Provider Demographics
NPI:1891936829
Name:KESTER, STUART GORDON (LMT)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:GORDON
Last Name:KESTER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 900265
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33090-0265
Mailing Address - Country:US
Mailing Address - Phone:305-775-5419
Mailing Address - Fax:305-242-2744
Practice Address - Street 1:15901 SW 288TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1158
Practice Address - Country:US
Practice Address - Phone:305-775-5419
Practice Address - Fax:305-242-2744
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-21
Last Update Date:2009-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55315172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist