Provider Demographics
NPI:1730548108
Name:LOTUS HEALTH CARE LLC
Entity type:Organization
Organization Name:LOTUS HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BHUPATIRAJU
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAJU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-668-9000
Mailing Address - Street 1:750 DESOTO AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-2814
Mailing Address - Country:US
Mailing Address - Phone:407-668-9000
Mailing Address - Fax:
Practice Address - Street 1:750 DESOTO AVE UNIT A
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-2814
Practice Address - Country:US
Practice Address - Phone:407-668-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0021368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty