Healthcare Provider Details

I. General information

NPI: 1073439535
Provider Name (Legal Business Name): MAGIMURA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1861 LIN MAR DR
WEST PALM BEACH FL
33406-5256
US

IV. Provider business mailing address

1861 LIN MAR DR
WEST PALM BEACH FL
33406-5256
US

V. Phone/Fax

Practice location:
  • Phone: 561-779-5571
  • Fax:
Mailing address:
  • Phone: 561-779-5571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CALVIN LABRADA
Title or Position: OWNER/MANAGING MEMBER
Credential:
Phone: 561-779-5571