MEDICARE: DR. DUSAN LEKIC MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A108722	CA
2	2084P0800X	Psychiatry Physician	234342	MA

General Provider Information

NPI Number	:	1174796973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUSAN LEKIC MD

Provider Business Mailing Address
First Line	:	579 NW LAKE WHITNEY PL STE 103
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-1622
Country	:	US
Telephone Number	:	772-249-5423
Fax Number	:

Provider Business Practice Location Address
First Line	:	4411 E. KINGS CANYON RD
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702
Country	:	US
Telephone Number	:	559-453-1008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	05/26/2026

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