Healthcare Provider Details

I. General information

NPI: 1134654700
Provider Name (Legal Business Name): CINDY MAGALY LLANTOY MOSQUERA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 NORTH MILITARY TRAIL
WEST PALM BEACH FL
33410
US

IV. Provider business mailing address

12213 89TH PL N
WEST PALM BEACH FL
33412-2374
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-5531
  • Fax:
Mailing address:
  • Phone: 561-727-7178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberISW11605
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: