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Individual

MR. MATELAND LESTERY KEITH III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP-ABC

Contact information

Practice address
1990 MAIN ST STE 750, SARASOTA, FL 34236-8000
(941) 367-2356
(941) 200-4201
Mailing address
1990 MAIN ST STE 750, SARASOTA, FL 34236-8000
(941) 367-2356
(941) 200-4201

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
28243714A
IN
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
28243714A
IN
163WP0808X
Psychiatric/Mental Health Registered Nurse
28243714A
IN
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
28243714A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11013737
FL

Other

Enumeration date
08/26/2020
Last updated
05/01/2025
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