Organization Active NPI

Lotus Pharmacy 1, LLC

  • Long Term Care Pharmacy
  • Ft Lauderdale, FL
National Provider Identifier
1093664229
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
LOTUS PHARMACY 1, LLC
Practice address
5410 NW 33Rd Ave Ste 107
Ft Lauderdale, FL 33309-0004
Phone
(833) 602-3336
Fax
(888) 756-3331
NPI assigned
Jan 22, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jill LytwynNPI 1063297315
Title
Ceo
Phone
(612) 425-9145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

5410 NW 33Rd Ave Ste 107
Ft Lauderdale, FL 33309-0004

Mailing address

5410 NW 33Rd Ave Ste 107
Ft Lauderdale, FL 33309-0004
Phone (833) 602-3336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260615000016 FL Part B Supplier - Pharmacy 4981176690 Practice locations: Ft Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

5410 NW 33rd Ave
Ste 107
Ft Lauderdale, FL 33309
Phone (833) 602-3336

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769731200000",
    "number": "1093664229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 NW 33RD AVE STE 107",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333090004",
            "telephone_number": "833-602-3336",
            "fax_number": "888-756-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 NW 33RD AVE STE 107",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333090004",
            "telephone_number": "833-602-3336",
            "fax_number": "888-756-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS PHARMACY 1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-22",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A",
        "authorized_official_last_name": "LYTWYN",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-425-9145"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.