Provider Demographics
NPI:1538781364
Name:BLUE LOTUS ENDOCRINE COMPANY INC
Entity type:Organization
Organization Name:BLUE LOTUS ENDOCRINE COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:ALLEN-RYAN
Authorized Official - Last Name:BARZEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-573-0064
Mailing Address - Street 1:18938 N DALE MABRY HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4904
Mailing Address - Country:US
Mailing Address - Phone:813-573-0064
Mailing Address - Fax:
Practice Address - Street 1:18938 N DALE MABRY HWY STE 101
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4904
Practice Address - Country:US
Practice Address - Phone:813-573-0064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty