Provider Demographics
NPI:1033916903
Name:MAGIC THERAPY LLC
Entity type:Organization
Organization Name:MAGIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYLEISHKA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES AGOSTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-205-7782
Mailing Address - Street 1:PO BOX 2061
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-4061
Mailing Address - Country:US
Mailing Address - Phone:787-664-4884
Mailing Address - Fax:
Practice Address - Street 1:CARR. 153 CENTRO RODAL A1 KM 9.6
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-664-4884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty