OrganizationActive
Lee Memorial Health System
NPI 1164051405 · Federally Qualified Health Center (FQHC) · Port Charlotte, FL
Provider details
- NPI number
- 1164051405
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Joseph Niebergall, Credentialing Specialist(239) 424-1446
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2484 Caring Way Unit F
Port Charlotte, FL 33952-5306
Phone: (941) 625-1999
Fax: (941) 625-4600
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 2147
Fort Myers, FL 33902-2147
Other names (DBA / former)
- Doing business as
- Lch-Peds PC#1
Registry dates
- Enumerated
- 2020-04-08
- Last updated
- 2020-04-08
- Certified
- 2020-04-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.