Healthcare Provider Details

I. General information

NPI: 1447862586
Provider Name (Legal Business Name): TERESA KOLIHA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 N BAY RD
MIAMI BEACH FL
33140-2844
US

IV. Provider business mailing address

4251 N BAY RD
MIAMI BEACH FL
33140-2844
US

V. Phone/Fax

Practice location:
  • Phone: 305-244-2418
  • Fax:
Mailing address:
  • Phone: 305-244-2418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number9458904
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9458904
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: