MEDICARE: A MAGIC WORLD CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM3000X	Medically Fragile Infants and Children Day Care

General Provider Information

NPI Number	:	1164179016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A MAGIC WORLD CORP

Provider Business Mailing Address
First Line	:	2250 PALM BEACH LAKES BLVD STE 106A
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3407
Country	:	US
Telephone Number	:	561-568-1854
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 PALM BEACH LAKES BLVD STE 106A
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3407
Country	:	US
Telephone Number	:	561-568-1854
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAIZA JIMENEZ DORTA
Credential	:
Telephone Number	:	561-568-1584

Provider Enumeration Date	:	03/09/2022
Last Update Date	:	03/09/2022

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Directions to “A MAGIC WORLD CORP ” Practice Location

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