Healthcare Provider Details

I. General information

NPI: 1730980236
Provider Name (Legal Business Name): MS. ELAINA DIANA TOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 CENTER PLACE WAY
ST AUGUSTINE FL
32095-8859
US

IV. Provider business mailing address

180 CENTER PLACE WAY
ST AUGUSTINE FL
32095-8859
US

V. Phone/Fax

Practice location:
  • Phone: 904-342-7103
  • Fax:
Mailing address:
  • Phone: 904-342-7103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberT632123443000
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: