Provider Demographics
NPI:1659925568
Name:MAZALTOV, LLC
Entity Type:Organization
Organization Name:MAZALTOV, LLC
Other - Org Name:HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINAKOLI
Authorized Official - Suffix:
Authorized Official - Credentials:BSC,MSC
Authorized Official - Phone:561-479-9350
Mailing Address - Street 1:1645 PALM BEACH LAKES BLVD STE 1200
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2214
Mailing Address - Country:US
Mailing Address - Phone:561-465-5920
Mailing Address - Fax:561-465-5433
Practice Address - Street 1:1645 PALM BEACH LAKES BLVD STE 1200
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2214
Practice Address - Country:US
Practice Address - Phone:561-465-5920
Practice Address - Fax:561-465-5433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30211970OtherAHCA