Organization · NPI-2

Blue Lotus Wellness, LLC

Clinic/Center, Physical Therapy · Ocoee, FL

NPI number1982224853

StatusActive

Last updated in NPPESOct 20, 2020

Details

NPI: 1982224853
Entity type: Organization (NPI-2)
Legal business name: Blue Lotus Wellness, LLC
Organization subpart: No
Enumeration date: Apr 21, 2020
Certification date: Oct 19, 2020
Last updated: Oct 20, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QP2000X	Clinic/Center, Physical Therapy	–	–	Yes
225100000X	Physical Therapist	–	–
225200000X	Physical Therapy Assistant	–	–
225X00000X	Occupational Therapist	–	–
225XP0019X	Occupational Therapist, Physical Rehabilitation	–	–
235Z00000X	Speech-Language Pathologist,	–	–
261Q00000X	Clinic/Center	–	–

Practice location

368 Moore Rd
Ocoee, FL 34761-4871

Phone 407-614-5061

Mailing address

368 Moore Rd
Ocoee, FL 34761-4871

Phone 407-614-5061

Authorized official

Margaret Barnett Latham
Owner
4076145061

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