MEDICARE: MRS. TERESA KOLIHA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	9458904	FL
2	163WG0000X	General Practice Registered Nurse	9458904	FL

General Provider Information

NPI Number	:	1447862586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERESA KOLIHA RN

Provider Business Mailing Address
First Line	:	4251 N BAY RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2844
Country	:	US
Telephone Number	:	305-244-2418
Fax Number	:

Provider Business Practice Location Address
First Line	:	4251 N BAY RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2844
Country	:	US
Telephone Number	:	305-244-2418
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2020
Last Update Date	:	08/19/2020

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