Basic Information
| Provider Information | |||||||||
| NPI: | 1821029018 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LESTER | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | LANCELOT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 JFK DR | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | ATLANTIS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334626607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615484900 | ||||||||
| FaxNumber: | 5614345158 | ||||||||
| Practice Location | |||||||||
| Address1: | 180 JFK DR | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | ATLANTIS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334626607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615484900 | ||||||||
| FaxNumber: | 5614345158 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 06/19/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | ME014556 | FL | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
ID Information
| ID | Type | State | Issuer | Description | 280131100 | 05 | FL | MEDICAID | 068614000 | 05 | FL | MEDICAID |