Healthcare Provider Details

I. General information

NPI: 1104458769
Provider Name (Legal Business Name): MAVA HEALTHCARE SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2971 PARK POND WAY
KISSIMMEE FL
34741-7661
US

IV. Provider business mailing address

1834 DERBY GLEN DR
ORLANDO FL
32837-8102
US

V. Phone/Fax

Practice location:
  • Phone: 407-775-2121
  • Fax:
Mailing address:
  • Phone: 321-287-6866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: IFFAT ZAHEER
Title or Position: OWNER
Credential:
Phone: 407-775-2121