Provider Demographics
NPI:1760625925
Name:LEXIS PROFESSIONAL SERVICE INC
Entity Type:Organization
Organization Name:LEXIS PROFESSIONAL SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEDIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-910-8071
Mailing Address - Street 1:8770 SUNSET DR
Mailing Address - Street 2:SUITE 512
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3512
Mailing Address - Country:US
Mailing Address - Phone:305-910-8071
Mailing Address - Fax:305-513-5189
Practice Address - Street 1:8770 SUNSET DR
Practice Address - Street 2:SUITE 512
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3512
Practice Address - Country:US
Practice Address - Phone:305-910-8071
Practice Address - Fax:305-513-5189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34153305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization