Provider Demographics
NPI:1558301275
Name:NEGRON-AYALA, LESTER V (MD)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:V
Last Name:NEGRON-AYALA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1580 SANTA BARBARA BLVD
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6827
Mailing Address - Country:US
Mailing Address - Phone:352-259-2159
Mailing Address - Fax:352-259-5731
Practice Address - Street 1:1580 SANTA BARBARA BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-259-2159
Practice Address - Fax:352-259-5731
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2018-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR16339208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0028584Medicare PIN