| Lch-internal Medicine Matthew Drive | |
|
1569 Matthew Dr Fort Myers FL 33907-1734 | |
| (239) 343-8220 | |
| (239) 468-7909 |
| Full Name | Lch-internal Medicine Matthew Drive |
|---|---|
| Speciality | Clinic/Center |
| Location | 1569 Matthew Dr, Fort Myers, Florida |
| Authorized Official Name and Position | Joseph Niebergall (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2394241446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lch-internal Medicine Matthew Drive Po Box 2147 Fort Myers FL 33902-2147 Ph: (239) 343-8220 | Lch-internal Medicine Matthew Drive 1569 Matthew Dr Fort Myers FL 33907-1734 Ph: (239) 343-8220 |
| NPI Number | 1013790393 |
|---|---|
| Provider Enumeration Date | 08/18/2023 |
| Last Update Date | 09/14/2023 |
| Medicare PECOS PAC ID | 8729996608 |
|---|---|
| Medicare Enrollment ID | O20231004003185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013790393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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