Lee County Trauma Services District

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

Legal business name

LEE COUNTY TRAUMA SERVICES DISTRICT

Practice address

13685 Doctors Way Ste 100
Fort Myers, FL 33912-4337

Phone

(239) 343-1612

Fax

(239) 343-4229

NPI assigned

Jan 4, 2007

Last updated

Nov 6, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Larry Antonucci

Title

President,Ceo

Phone

(239) 343-6537

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maria E Alfaro-Maguyon, MD

  • Trauma Surgery Physician
  • Fort Myers, FL
  • NPI 1669884078
  Medicare reassignment NPD
• Lilly Ann Bayouth, M.D.

  • Trauma Surgery Physician
  • Fort Myers, FL
  • NPI 1053731133
  Medicare reassignment NPD
• Jose A Diaz, MD

  • Trauma Surgery Physician
  • Fort Myers, FL
  • NPI 1548415086
  Medicare reassignment NPD
• Michael D Fromke, MD

  • Neurological Surgery Physician
  • Fort Myers, FL
  • NPI 1144208406
  Medicare reassignment NPD
• Jeffrey S Henn, M.D.

  • Neurological Surgery Physician
  • Fort Myers, FL
  • NPI 1821064957
  Medicare reassignment NPD
• Zachary Allen Hothem, D.O.

  • Surgery Physician
  • Fort Myers, FL
  • NPI 1912260258
  Medicare reassignment NPD
• James E Kasiewicz, M.D.

  • Surgical Critical Care Physician
  • Fort Myers, FL
  • NPI 1619119922
  Medicare reassignment NPD
• Sergey Kozyr

  • Trauma Surgery Physician
  • Fort Myers, FL
  • NPI 1174937130
  Medicare reassignment NPD
• Joseph Robert Lewis, D.O.

  • Surgical Critical Care Physician
  • Fort Myers, FL
  • NPI 1831585199
  Medicare reassignment NPD
• Firas Madbak, M.D.

  • Surgical Critical Care Physician
  • Fort Myers, FL
  • NPI 1710150669
  Medicare reassignment NPD
• Owen S. Richardson, M.D.

  • Trauma Surgery Physician
  • Fort Myers, FL
  • NPI 1396178943
  Medicare reassignment NPD
• Piotr Sobolewski, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Myers, FL
  • NPI 1922559160
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1639226608",
    "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": "239-424-1500",
            "fax_number": "239-424-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13685 DOCTORS WAY STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124337",
            "telephone_number": "239-343-1612",
            "fax_number": "239-343-4229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 Cleveland Ave",
            "address_2": "Suite 702",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015858",
            "country_code": "US",
            "telephone_number": "239-332-6400",
            "fax_number": "239-334-5968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEE COUNTY TRAUMA SERVICES DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "ANTONUCCI",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT,CEO",
        "authorized_official_telephone_number": "239-343-6537"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268529900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee County Medical Center, Inc
• Lee County Medical Institute Corp
• Lee County Medical Solutions Inc.
• Lee County MRI Inc (Tesla MRI)
• Lee County Physical Medicine LLC
• Lee Dental Care
• Lee Health Care Associates LLC (Heritage Park Rehabilitation and Healthcare)
• Lee Health System Inc
• Lee Health System Inc
• Lee Health System Inc

• Trauma Surgery Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Trauma Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.