Provider Demographics
NPI:1851988752
Name:MAVLET MEDICAL LLC
Entity Type:Organization
Organization Name:MAVLET MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIZGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-747-5164
Mailing Address - Street 1:1615 S CONGRESS AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6326
Mailing Address - Country:US
Mailing Address - Phone:800-761-8806
Mailing Address - Fax:905-761-6651
Practice Address - Street 1:323 SUNNY ISLES BLVD FL 7
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4232
Practice Address - Country:US
Practice Address - Phone:800-761-8806
Practice Address - Fax:905-761-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-25
Last Update Date:2020-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care