Provider Demographics
NPI:1881030757
Name:ZAGOROVA, MAGDALENA EVELINOVA (MA)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:EVELINOVA
Last Name:ZAGOROVA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 NW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-2014
Mailing Address - Country:US
Mailing Address - Phone:646-657-4131
Mailing Address - Fax:
Practice Address - Street 1:8447 60TH RD
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-5406
Practice Address - Country:US
Practice Address - Phone:904-377-8696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FL16689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health