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General NPI Number Information
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NPI Number | 1154578128
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Entity Type | Organization
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Legal Business Name | CHRISTIAN ROMERO PSY D LICENSED PSYCHOLOGIST LLC
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 3393 MAGIC OAK LN
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City | SARASOTA
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State | FL
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Zip | 34232-1821
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Country | US
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Telephone | 941-421-4084
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Fax |
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Provider Business Mailing Address
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Address Line | 3393 MAGIC OAK LN
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City | SARASOTA
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State | FL
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Zip | 34232-1821
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Country | US
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Telephone | 941-421-4084
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. CHRISTIAN L ROMERO
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Credential | PSYD
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Telephone | 941-421-4084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY7763
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License Number State | FL
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