Active NPI
Lee Memorial Health System
Doing business as LCH FM Colonial
- Federally Qualified Health Center (FQHC)
- Fort Myers, FL
National Provider Identifier
1316720626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- LEE MEMORIAL HEALTH SYSTEM
- Doing business as
- LCH FM Colonial
LCH Sanctuary Family Medicine - Practice address
- 8960 Colonial Center Dr Ste 300
Fort Myers, FL 33905-7810 - Phone
- (239) 343-9470
- Fax
- (239) 343-9498
- NPI assigned
- Aug 18, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steven Boren
- Title
- Credential Specialist
- Phone
- (239) 424-1479
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
8960 Colonial Center Dr Ste 300
Fort Myers, FL 33905-7810
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (393) 439-4702
Other names 2
- LCH FM Colonial
- LCH Sanctuary Family Medicine
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692316800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694649600000",
"number": "1316720626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "393-439-4702",
"fax_number": "239-343-9498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8960 COLONIAL CENTER DR STE 300",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339057810",
"telephone_number": "239-343-9470",
"fax_number": "239-343-9498"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEE MEMORIAL HEALTH SYSTEM",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-18",
"last_updated": "2023-09-14",
"certification_date": "2023-09-14",
"status": "A",
"authorized_official_last_name": "BOREN",
"authorized_official_first_name": "STEVEN",
"authorized_official_title_or_position": "CREDENTIAL SPECIALIST",
"authorized_official_telephone_number": "239-424-1479"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "LCH FM Colonial",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "LCH Sanctuary Family Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fort Myers, FL
- Lee Memorial Health System
- Lee Memorial Health System (Lee Pharmacy 2)
- Lee Memorial Health System (LCH-Pediatric Nephrology)
- Lee Memorial Health System (LCH-Adult Neurology)
- Lee Memorial Health System (HealthPark Medical Center Pharmacy)
- Lee Memorial Health System (LCH-Adult Rheumatology)
- Lee Memorial Health System
- Lee Memorial Health System (LCH-Pediatric Gastroenterology)
- Lee Memorial Health System (LCH- Adult Infectious Disease)
- Lee Memorial Health System (LCH-Behavioral Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.