Provider Demographics
NPI:1013954098
Name:NAY, LESTON B (MD)
Entity Type:Individual
Prefix:DR
First Name:LESTON
Middle Name:B
Last Name:NAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9424 SW 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-3243
Mailing Address - Country:US
Mailing Address - Phone:352-215-7504
Mailing Address - Fax:352-672-6201
Practice Address - Street 1:5318 SW 91ST TER
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-8125
Practice Address - Country:US
Practice Address - Phone:352-375-5553
Practice Address - Fax:352-672-6201
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO148262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01148287Medicaid
COD22730Medicare UPIN
CO538928Medicare ID - Type Unspecified