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General NPI Number Information
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NPI Number | 1891206009
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Entity Type | Organization
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Legal Business Name | TOLI & FLO CREATIVE STUDIO, LLC
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Dates
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Enumeration Date | 10/14/2017
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Last Update Date | 10/14/2017
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Provider Practice Location Address
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Address Line | 8201 SW 24TH ST # 11
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City | MIAMI
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State | FL
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Zip | 33155-1263
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Country | US
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Telephone | 786-291-6564
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Fax |
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Provider Business Mailing Address
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Address Line | 7125 BONITA DR APT 402
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City | MIAMI BEACH
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State | FL
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Zip | 33141-3065
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Country | US
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Telephone | 786-488-5806
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ILEANA TOLIBIA
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Credential | LMHC
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Telephone | 786-291-6564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH13964
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License Number State | FL
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