Provider Demographics
NPI:1821008376
Name:ZALDIVAR, VIRGILIO MAGDIEL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:VIRGILIO
Middle Name:MAGDIEL
Last Name:ZALDIVAR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 SW 99TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2823
Mailing Address - Country:US
Mailing Address - Phone:305-216-6797
Mailing Address - Fax:
Practice Address - Street 1:1901 SW 1ST ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1601
Practice Address - Country:US
Practice Address - Phone:305-631-8933
Practice Address - Fax:305-631-0546
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW65511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical