Provider Demographics
NPI:1528331568
Name:LEE HEALTHCARE INC
Entity type:Organization
Organization Name:LEE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:239-362-3727
Mailing Address - Street 1:3660 CENTRAL AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-7699
Mailing Address - Country:US
Mailing Address - Phone:239-362-3727
Mailing Address - Fax:239-362-3756
Practice Address - Street 1:3660 CENTRAL AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7699
Practice Address - Country:US
Practice Address - Phone:239-362-3727
Practice Address - Fax:239-362-3756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90692207Q00000X
FLMA66063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty