Organization
FLORIDA DEPARTMENT OF HEALTH
Active
Other names
Lee County Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MALLETT (ASSISTANT DIRECTOR)
(239) 461-6148
Entity
Organization
Contact information
Practice address
83 PONDELLA RD, NORTH FORT MYERS, FL 33903-4411
(239) 461-6148
(239) 461-6160
Mailing address
83 PONDELLA RD, NORTH FORT MYERS, FL 33903-4411
(239) 461-6148
(239) 461-6160
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH10694
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027946309
—
FL
05
—
027946316
—
FL
01
—
1068154
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/08/2007
Last updated
11/09/2012
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