Provider Demographics
NPI:1235134529
Name:LESTER, LAWRENCE J (PT)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:LESTER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3194 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-1736
Mailing Address - Country:US
Mailing Address - Phone:727-519-0520
Mailing Address - Fax:727-532-0091
Practice Address - Street 1:13501 ICOT BLVD
Practice Address - Street 2:STE 110
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3729
Practice Address - Country:US
Practice Address - Phone:727-507-8555
Practice Address - Fax:727-532-0091
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY6405Medicare ID - Type Unspecified