DR. ROBERTA ANN WILDBLOOD (NPI# 1902298250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902298250 |
| Entity Type | Individual |
| Full Name | DR. ROBERTA ANN WILDBLOOD |
| Credential | PSYD, MS, RN |
| Practice Address |
1400 N Semoran Blvd Suite E Orlando FL 32807-3536 |
| Practice Telephone | 4078238421 |
| Practice Fax Number | 4078238195 |
| Mailing Telephone | 4078238421 |
| Mailing Fax Number | 4078238195 |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PY8711 | FL | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PY8711 | FL | Behavioral Health & Social Service Providers |
| Street Address |
1400 N SEMORAN BLVD SUITE E |
| City | ORLANDO |
| State | FL |
| Zip Code | 32807-3536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710934492 | Nellie Ofarrill | Family Medicine | 1400 N Semoran Blvd, Orlando, FL 32807-3536 | 2006-05-28 |
| 1427604479 | Brandon Rothenberg | Counselor | 1400 N Semoran Blvd, Orlando, FL 32807-3536 | 2019-08-15 |
| 1598253197 | Elisabeth Shields | Counselor | 1400 N Semoran Blvd, Orlando, FL 32807-3536 | 2018-04-29 |
| 1609378645 | Lisset Gunes | Student in an Organized Health Care Education/Training Program | 1400 N Semoran Blvd, Orlando, FL 32807-3536 | 2018-03-06 |
| 1245748276 | Gerardo De Jesus | Counselor | 1400 N Semoran Blvd, Orlando, FL 32807-3536 | 2018-01-11 |
| 1164945036 | John Fredy Giraldo | Behavioral Analyst | 1400 N Semoran Blvd, Orlando, FL 32807-3536 | 2017-07-21 |
| 1023568334 | Karina Flores | Social Worker | 1400 N Semoran Blvd, Orlando, FL 32807-3536 | 2016-10-11 |
| 1790157626 | Compass Counseling Services,llc | Community/Behavioral Health | 1400 N Semoran Blvd, Suite E, Orlando, FL 32807-3536 | 2015-10-30 |
| 1023493186 | Erin Nurse | Counselor | 1400 N Semoran Blvd, Suite E, Orlando, FL 32807-3536 | 2015-07-29 |
| 1861801383 | Merly E. Hamilton | Counselor | 1400 N Semoran Blvd, Suite E, Orlando, FL 32807-3536 | 2014-08-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922668037 | Javier Urshela | Rehabilitation Counselor | 1150 S Semoran Blvd Suite A, Orlando, FL 32807 | 2019-06-20 |
| 1326602087 | Darnell Maurice Avent | Counselor | 7835 Pine Crossing Circle, Apt: 1038, Orlando, FL 32807 | 2019-04-29 |
| 1689185233 | Janea Mark | Technician/Technologist | 2242 Gator Drive, 326, Orlando, FL 32807 | 2017-10-22 |
| 1659813863 | Yaritza Joan Mattei Collado | Speech-Language Pathologist | 1136 Farwell, Orlando, FL 32807 | 2016-11-07 |
| 1316495815 | Grimarie Fernandez | Counselor | 1601 N. Goldenrod Rd. Suite 2, A Great Life, Inc, Orlando, FL 32807 | 2016-09-14 |
| 1922473958 | Adam Brett Lowery | Counselor | 1400 Semoran Blvd, Orlando, FL 32807 | 2015-12-02 |
| 1396115093 | Peterson Jean-baptiste | Counselor | 7835 Pine Crossing Circle, Apt. 1027, Orlando, FL 32807 | 2015-10-07 |
| 1396121380 | Sonia Vega | Case Management | 1601 N. Goldenrod Rd., Orlando, FL 32807 | 2015-08-03 |
| 1386036069 | Guidewell Emergency Medicine Doctors | Clinic/Center | 1706 N Semoran Blvd, Orlando, FL 32807 | 2015-03-04 |
| 1821339276 | Cac- Florida Medical Centers LLC | Clinic/Center | 737 South Semoran Blvd, Orlando, FL 32807 | 2013-03-11 |
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| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
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| 1336553817 | Setenov Enterprise Corporation | Psychologist | 9702 Universal Blvd, B-325, Orlando, FL 32819-8721 | 2014-06-12 |
| 1679086359 | Rachel M Wasserman | Psychologist | 13535 Nemours Pkwy, Orlando, FL 32827-7402 | 2017-11-16 |
| 1437567989 | Jessica S Pierce | Psychologist | 1717 S Orange Ave, Suite 100, Orlando, FL 32806-2944 | 2014-07-29 |
| 1205172046 | John Grbac, Psy.d., P.l. | Psychologist | 1630 Hillcrest St, Orlando, FL 32803-4810 | 2012-12-26 |
| 1801049150 | Lisa C Gibbons | Psychologist | 100 W Gore St Ste 405, Orlando, FL 32806-1049 | 2008-10-30 |
| 1992814750 | Leslie A. Gavin-devitt | Psychologist | 1717 S Orange Ave, Suite 100, Orlando, FL 32806-2944 | 2006-08-29 |
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| 1346738705 | Tampa Psychology Group | Psychologist | 1463 Oakfield Dr Ste 109, Brandon, FL 33511 | 2018-05-01 |
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| 1073028734 | Audra Walsh, Phd, LLC | Psychologist | 1039 Park St N, St Petersburg, FL 33710-4317 | 2017-12-04 |
| 1801327564 | Paola Granados-radlick | Psychologist | 1200 Brickell Ave Ste 850, Miami, FL 33131-3212 | 2017-03-24 |
| 1205388527 | Safe Landing, Inc | Psychologist | 9200 Nw 8th Ave, Miami, FL 33150-2016 | 2016-11-03 |
| 1124574595 | Michelle C Fernandez | Psychologist | 7800 Sw 57th Avenue Suite 114, South Miami, FL 33143 | 2016-08-26 |
| 1952764060 | Penelope L. Norton, Phd | Psychologist | 555 W Granada Blvd Ste E3, Ormond Beach, FL 32174-9401 | 2016-04-05 |
| 1033574686 | Erika Tornatore | Psychologist | 1485 S Semoran Blvd., Suite 1448, Winter Park, FL 32792 | 2015-12-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.