Provider Demographics
NPI:1881386829
Name:CHAPON, LEE MICHAEL
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:MICHAEL
Last Name:CHAPON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14208 PINE LODGE LN
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-9474
Mailing Address - Country:US
Mailing Address - Phone:321-508-6150
Mailing Address - Fax:
Practice Address - Street 1:14208 PINE LODGE LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-9474
Practice Address - Country:US
Practice Address - Phone:321-508-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033563367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered