Provider Demographics
NPI:1285763359
Name:LOTUS HEART HOLISTIC CENTER TOO
Entity type:Organization
Organization Name:LOTUS HEART HOLISTIC CENTER TOO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:321-259-5056
Mailing Address - Street 1:3084 LAKE WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-7613
Mailing Address - Country:US
Mailing Address - Phone:321-259-5056
Mailing Address - Fax:321-259-5057
Practice Address - Street 1:3084 LAKE WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-7613
Practice Address - Country:US
Practice Address - Phone:321-259-5056
Practice Address - Fax:321-259-5057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA45958225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty