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General NPI Number Information
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NPI Number | 1295110435
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Entity Type | Individual
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Provider Name | JENNIFER ROMAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 9570 SW HIGHWAY 200
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City | OCALA
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State | FL
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Zip | 34481
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Country | US
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Telephone | 407-301-1614
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 772126
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City | OCALA
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State | FL
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Zip | 34477-2126
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Country | US
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Telephone | 352-291-1882
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Fax | 352-291-1891
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 5061
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License Number State | FL
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