Provider Demographics
NPI:1861767261
Name:MORETTI, LEE ANNE (PA)
Entity type:Individual
Prefix:MISS
First Name:LEE
Middle Name:ANNE
Last Name:MORETTI
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:8431 AUSTRIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33982-7201
Mailing Address - Country:US
Mailing Address - Phone:716-982-6581
Mailing Address - Fax:
Practice Address - Street 1:6150 DIAMOND CENTRE CT BLDG 100
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4367
Practice Address - Country:US
Practice Address - Phone:239-768-6396
Practice Address - Fax:239-204-3000
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2022-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY23015514363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical