Healthcare Provider Details
I. General information
NPI: 1801340989
Provider Name (Legal Business Name): CECILIA CRISTINA ROMAN BCBA, FNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/07/2016
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16130 SW 100TH LN
MIAMI FL
33196-6159
US
IV. Provider business mailing address
16130 SW 100TH LN
MIAMI FL
33196-6159
US
V. Phone/Fax
- Phone: 786-738-4252
- Fax:
- Phone: 786-738-4252
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN9213585 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | ARNP9213585 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-26-89374 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: