Provider Demographics
NPI:1306382411
Name:RESTESIA LLC
Entity Type:Organization
Organization Name:RESTESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHILEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:LAKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-360-1566
Mailing Address - Street 1:PO BOX 3344
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62708-3344
Mailing Address - Country:US
Mailing Address - Phone:941-360-1566
Mailing Address - Fax:941-358-9818
Practice Address - Street 1:1939 ROLAND CLARKE PL
Practice Address - Street 2:SUITE 200
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1443
Practice Address - Country:US
Practice Address - Phone:703-766-2650
Practice Address - Fax:941-358-9818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty