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General NPI Number Information
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NPI Number | 1033902929
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Entity Type | Organization
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Legal Business Name | TIKVAH HEALING GROUP
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 2332 GALIANO ST FL 2
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City | CORAL GABLES
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State | FL
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Zip | 33134-5402
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Country | US
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Telephone | 305-204-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 5612 CARRARA DR
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City | AVE MARIA
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State | FL
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Zip | 34142-5248
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Country | US
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Telephone | 305-742-1642
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | TIJUANA TOLEDO
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Credential | LCSW
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Telephone | 305-204-1665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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