Provider Demographics
NPI:1700023652
Name:LOTUS ACUPUNCTURE AND WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:LOTUS ACUPUNCTURE AND WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-422-4434
Mailing Address - Street 1:1521 ALTON RD
Mailing Address - Street 2:SUITE 186
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3301
Mailing Address - Country:US
Mailing Address - Phone:786-422-4434
Mailing Address - Fax:
Practice Address - Street 1:1515 N UNIVERSITY DR
Practice Address - Street 2:SUITE 208
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6096
Practice Address - Country:US
Practice Address - Phone:954-341-9696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty