Healthcare Provider Details

I. General information

NPI: 1205666930
Provider Name (Legal Business Name): LESTER YANIER RAMOS MERAYOS APRN, FNP-C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4715 S FLORIDA AVE
LAKELAND FL
33813-2126
US

IV. Provider business mailing address

425 W COLONIAL DR STE 303
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 863-209-7004
  • Fax:
Mailing address:
  • Phone: 321-332-6947
  • Fax: 689-304-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11034725
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: