MEDICARE: LXR HOME HEALTH SERVICES LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1841435492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LXR HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	6073 NW 167TH ST
Second Line	:	UNIT C-19
City	:	HIALEAH
State	:	FL
Zip	:	33015-4336
Country	:	US
Telephone Number	:	305-512-1439
Fax Number	:	305-512-1439

Provider Business Practice Location Address
First Line	:	6073 NW 167TH ST
Second Line	:	UNIT C-19
City	:	HIALEAH
State	:	FL
Zip	:	33015-4336
Country	:	US
Telephone Number	:	305-512-1439
Fax Number	:	305-512-1439

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JOSE L PEREZ
Credential	:
Telephone Number	:	305-512-1440

Provider Enumeration Date	:	12/11/2008
Last Update Date	:	12/11/2008

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Directions to “LXR HOME HEALTH SERVICES LLC ” Practice Location

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