MEDICARE: WORKS OF WELLNESS INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse
2	332900000X	Non-Pharmacy Dispensing Site
3	364SP0807X	Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
4	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist
5	364SP0813X	Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
6	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1770170813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORKS OF WELLNESS INC

Provider Business Mailing Address
First Line	:	4702 ASHBURN SQUARE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-5958
Country	:	US
Telephone Number	:	813-368-1126
Fax Number	:

Provider Business Practice Location Address
First Line	:	5118 N 56TH ST STE 111
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-5440
Country	:	US
Telephone Number	:	813-368-1126
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHERI BELLENGER
Credential	:	ARNP
Telephone Number	:	813-368-1126

Provider Enumeration Date	:	12/23/2020
Last Update Date	:	12/23/2020

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