MEDICARE: LENSKY JOSE HERNANDEZ SANTIAGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1629584446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LENSKY JOSE HERNANDEZ SANTIAGO

Provider Business Mailing Address
First Line	:	175 FONTAINEBLEAU BLVD STE 2G6A
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33172-7012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 FONTAINEBLEAU BLVD STE 2G6A
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33172-7012
Country	:	US
Telephone Number	:	786-325-5079
Fax Number	:	786-325-5079

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2017
Last Update Date	:	12/15/2017

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Directions to “ LENSKY JOSE HERNANDEZ SANTIAGO ” Practice Location

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