Healthcare Provider Details

I. General information

NPI: 1083016190
Provider Name (Legal Business Name): JENNA BUDREAU-ROMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BRICKELL AVE # 50093940
MIAMI FL
33131-2809
US

IV. Provider business mailing address

777 BRICKELL AVE # 50093940
MIAMI FL
33131-2809
US

V. Phone/Fax

Practice location:
  • Phone: 305-902-3660
  • Fax:
Mailing address:
  • Phone: 305-902-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY12097
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: