Healthcare Provider Details

I. General information

NPI: 1811534225
Provider Name (Legal Business Name): JOELLE ROBLES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10125 W COLONIAL DR
OCOEE FL
34761-4209
US

IV. Provider business mailing address

10125 W COLONIAL DR
OCOEE FL
34761-4209
US

V. Phone/Fax

Practice location:
  • Phone: 407-753-7441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10772
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: