Provider Demographics
NPI:1972102499
Name:ONE SOULE TEAM INC
Entity Type:Organization
Organization Name:ONE SOULE TEAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:DI CARLO
Authorized Official - Suffix:
Authorized Official - Credentials:MS-SLP-CCC
Authorized Official - Phone:305-439-3488
Mailing Address - Street 1:1177 71ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3645
Mailing Address - Country:US
Mailing Address - Phone:305-763-8993
Mailing Address - Fax:305-763-8029
Practice Address - Street 1:1177 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3645
Practice Address - Country:US
Practice Address - Phone:305-763-8993
Practice Address - Fax:305-763-8029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8993OtherBOARD OF A SPEECH AND LANGUAGE THERAPY