Healthcare Provider Details

I. General information

NPI: 1013283308
Provider Name (Legal Business Name): LINDA CIOTOLI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 07/08/2023
Certification Date: 07/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WESTHALL LN STE 207
MAITLAND FL
32751-7478
US

IV. Provider business mailing address

2115 W DEKLE AVE APT D3
TAMPA FL
33606-3194
US

V. Phone/Fax

Practice location:
  • Phone: 800-840-2528
  • Fax:
Mailing address:
  • Phone: 813-504-4886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH22458
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH17058
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: