MEDICARE: DR. CHRISTINA CALDWELL PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PY9296	FL
2	103TC0700X	Clinical Psychologist	013916	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437151925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA CALDWELL PSY.D.

Provider Business Mailing Address
First Line	:	PO BOX 1327
Second Line	:
City	:	MINNEOLA
State	:	FL
Zip	:	34755-1327
Country	:	US
Telephone Number	:	352-396-1086
Fax Number	:

Provider Business Practice Location Address
First Line	:	5462 HOFFNER AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-2522
Country	:	US
Telephone Number	:	352-396-1086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	12/30/2020

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