Provider Demographics
NPI:1619367976
Name:L.O.T. HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:L.O.T. HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGALI
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-693-5143
Mailing Address - Street 1:11924 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 10A-243
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6256
Mailing Address - Country:US
Mailing Address - Phone:561-693-5143
Mailing Address - Fax:
Practice Address - Street 1:845 PALM BEACH RD
Practice Address - Street 2:
Practice Address - City:SOUTH BAY
Practice Address - State:FL
Practice Address - Zip Code:33493-2037
Practice Address - Country:US
Practice Address - Phone:561-693-5143
Practice Address - Fax:561-245-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW86091041C0700X
FLME108802174400000X, 207RC0000X, 261QM1300X
FLME49236207R00000X
FLME68559208000000X
208D00000X
FLPA9103904363AM0700X
FLARNP9276312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109195200Medicaid
FL273553900Medicaid