Healthcare Provider Details

I. General information

NPI: 1922545581
Provider Name (Legal Business Name): LESTER TRASTOY APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2017
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 NW 7TH ST STE 822
MIAMI FL
33126-3435
US

IV. Provider business mailing address

13941 SW 39TH ST
MIAMI FL
33175-6422
US

V. Phone/Fax

Practice location:
  • Phone: 305-260-6615
  • Fax:
Mailing address:
  • Phone: 305-773-5717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number76178
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11048684
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number12-197
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: