MEDICARE: LYEN MEDICAL EQUIPMENT,INC.

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	2148	FL

General Provider Information

NPI Number	:	1982606364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYEN MEDICAL EQUIPMENT,INC.

Provider Business Mailing Address
First Line	:	6555 NW 36TH ST
Second Line	:	STE 201-A
City	:	VIRGINIA GARDENS
State	:	FL
Zip	:	33166-6978
Country	:	US
Telephone Number	:	305-870-0380
Fax Number	:	305-870-0381

Provider Business Practice Location Address
First Line	:	6555 NW 36TH ST
Second Line	:	STE 201-A
City	:	VIRGINIA GARDENS
State	:	FL
Zip	:	33166-6978
Country	:	US
Telephone Number	:	305-870-0380
Fax Number	:	305-870-0381

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. NELIS BAHDER
Credential	:
Telephone Number	:	305-870-0380

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	12/15/2009

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Directions to “LYEN MEDICAL EQUIPMENT,INC. ” Practice Location

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