Healthcare Provider Details

I. General information

NPI: 1871421750
Provider Name (Legal Business Name): NICOLE LOTTERMANN L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 GLADES RD STE B
BOCA RATON FL
33432-1642
US

IV. Provider business mailing address

32 NW 12TH AVE
BOCA RATON FL
33486-3467
US

V. Phone/Fax

Practice location:
  • Phone: 561-484-2768
  • Fax:
Mailing address:
  • Phone: 561-716-2001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP4052
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: