Healthcare Provider Details

I. General information

NPI: 1811092174
Provider Name (Legal Business Name): ANITA MAGUN L,C,S,W,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 S OCEAN BLVD PH 1
HIGHLAND BEACH FL
33487-5390
US

IV. Provider business mailing address

4600 S OCEAN BLVD PH 1
HIGHLAND BEACH FL
33487-5390
US

V. Phone/Fax

Practice location:
  • Phone: 561-447-8604
  • Fax:
Mailing address:
  • Phone: 561-447-8604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 5618
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: