Healthcare Provider Details

I. General information

NPI: 1437048493
Provider Name (Legal Business Name): LIEBE CORNELIA HOOVES TO HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5938 HOVAN AVE
PLANT CITY FL
33565-3593
US

IV. Provider business mailing address

1211 TECH BLVD STE 145
TAMPA FL
33619-7845
US

V. Phone/Fax

Practice location:
  • Phone: 813-219-0097
  • Fax:
Mailing address:
  • Phone: 813-412-5881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICOLE BUONAMIA
Title or Position: COO
Credential:
Phone: 813-679-8376