Provider Demographics
NPI:1114111507
Name:SHRESTHA, LESS K (MD)
Entity Type:Individual
Prefix:
First Name:LESS
Middle Name:K
Last Name:SHRESTHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 ESPLANADE WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-0802
Mailing Address - Country:US
Mailing Address - Phone:850-431-3867
Mailing Address - Fax:850-431-3879
Practice Address - Street 1:3900 ESPLANADE WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-0802
Practice Address - Country:US
Practice Address - Phone:850-431-3867
Practice Address - Fax:850-431-3879
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54119207R00000X
FLME119768207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine