Healthcare Provider Details

I. General information

NPI: 1346955978
Provider Name (Legal Business Name): LOTUS CARE AT HOME PALM BEACH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOTUS CARE AT HOME PALM BEACH, LLC 1650 S DIXIE HWY STE 405
BOCA RATON FL
33432-3343
US

IV. Provider business mailing address

1650 S DIXIE HWY STE 405
BOCA RATON FL
33432-7462
US

V. Phone/Fax

Practice location:
  • Phone: 786-806-8611
  • Fax: 305-503-8225
Mailing address:
  • Phone: 786-806-8611
  • Fax: 305-503-8225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA VEGA
Title or Position: ADMINISTRATOR
Credential:
Phone: 786-806-8611