Provider Demographics
NPI:1902611601
Name:LYONS, BOBBY LEWIS II (MS)
Entity type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:LEWIS
Last Name:LYONS
Suffix:II
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 NW N RIVER DR APT 2016
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-2878
Mailing Address - Country:US
Mailing Address - Phone:407-683-1048
Mailing Address - Fax:
Practice Address - Street 1:2704 REW CIR STE 105B
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2994
Practice Address - Country:US
Practice Address - Phone:407-683-1048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH26308101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health