Provider Demographics
NPI:1760441851
Name:LESTER, ROBIN D (PA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:LESTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 SE 12TH ST
Mailing Address - Street 2:OCALA
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2651
Mailing Address - Country:US
Mailing Address - Phone:352-804-6290
Mailing Address - Fax:352-840-0757
Practice Address - Street 1:2244 SE 12TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2651
Practice Address - Country:US
Practice Address - Phone:352-804-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 2404363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292477300Medicaid
P00344017OtherRAILROAD
S71456Medicare UPIN
FL292477300Medicaid