Provider Demographics
NPI:1538851001
Name:HESTER, LEE M
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:M
Last Name:HESTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 CITRUS BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-7204
Mailing Address - Country:US
Mailing Address - Phone:352-326-3393
Mailing Address - Fax:352-326-8625
Practice Address - Street 1:2501 CITRUS BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7204
Practice Address - Country:US
Practice Address - Phone:352-326-3393
Practice Address - Fax:352-326-8625
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO2683156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician