Provider Demographics
NPI:1710474861
Name:LYN TIGER LLC
Entity Type:Organization
Organization Name:LYN TIGER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIRLENIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCALONA HERNADEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-454-0578
Mailing Address - Street 1:146 PEARY CT UNIT B
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-7744
Mailing Address - Country:US
Mailing Address - Phone:786-454-0578
Mailing Address - Fax:
Practice Address - Street 1:146 PEARY CT UNIT B
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-7744
Practice Address - Country:US
Practice Address - Phone:786-454-0578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-15
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLE245620747090343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid