Provider Demographics
NPI:1659925568
Name:MAZALTOV, LLC
Entity type:Organization
Organization Name:MAZALTOV, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:2001 PALM BEACH LAKES BLVD STE 300M
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6515
Mailing Address - Country:US
Mailing Address - Phone:561-430-2091
Mailing Address - Fax:561-898-1021
Practice Address - Street 1:2001 PALM BEACH LAKES BLVD STE 300M
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6515
Practice Address - Country:US
Practice Address - Phone:561-430-2091
Practice Address - Fax:561-898-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30211970OtherAHCA