Individual
BRYAN LEKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 PRUDENTIAL DR STE 304, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME83123
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263463500
—
FL
05
—
722986627C
—
GA
01
—
K1951A
BPC GROUP PTAN
FL
01
—
P00058037
RR MEDICARE
FL
Enumeration date
02/02/2006
Last updated
09/11/2024
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