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NPI Code Detail

MEDICARE: MS. ROSE MARIE LOTT

MEDICARE: MS. ROSE MARIE LOTT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH17628FL

General Provider Information

NPI Number : 1063021541
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSE MARIE LOTT
Provider Business Mailing Address
First Line : 2151 W HILLSBORO BLVD STE 203
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33442-1275
Country : US
Telephone Number : 954-426-0410
Fax Number :
Provider Business Practice Location Address
First Line : 5025 ASHLEY LAKE DR # 2-013
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-3175
Country : US
Telephone Number : 863-801-8195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2020
Last Update Date : 07/30/2020

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