Healthcare Provider Details

I. General information

NPI: 1427263490
Provider Name (Legal Business Name): CHOICEWORKS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 N SEMORAN BLVD SUITE 201
ORLANDO FL
32807-3555
US

IV. Provider business mailing address

1417 N SEMORAN BLVD SUITE 201
ORLANDO FL
32807-3555
US

V. Phone/Fax

Practice location:
  • Phone: 407-273-5010
  • Fax: 407-282-0552
Mailing address:
  • Phone: 407-273-5010
  • Fax: 407-282-0552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY4446
License Number StateFL

VIII. Authorized Official

Name: DR. J. LISA WELLS
Title or Position: PSYCHOLOGIST
Credential: PSY.D.
Phone: 407-273-5010