Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 14826 | CO |
NPI | 1013954098 |
---|---|
Provider Name | Dr. Leston B Nay |
First Address | Gainesville, FL 32607-3243 |
Second Address | Gainesville, FL 32608-8125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 13/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01148287 | (05) | CO |
D22730 | (02) | CO |