Healthcare Provider Details
I. General information
NPI: 1659925568
Provider Name (Legal Business Name): MAZALTOV, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2019
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 PALM BEACH LAKES BLVD STE 300M
WEST PALM BEACH FL
33409-6515
US
IV. Provider business mailing address
2001 PALM BEACH LAKES BLVD STE 300M
WEST PALM BEACH FL
33409-6515
US
V. Phone/Fax
- Phone: 561-430-2091
- Fax: 561-898-1021
- Phone: 561-430-2091
- Fax: 561-898-1021
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ELIDA
SINAKOLI
Title or Position: OWNER/ADMINISTRATOR
Credential: BSC,MSC
Phone: 561-479-9350