MEDICARE: KARLA ROMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1376341511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA ROMAN

Provider Business Mailing Address
First Line	:	1492 COUNTRY VILLA CT
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-5040
Country	:	US
Telephone Number	:	305-323-4230
Fax Number	:

Provider Business Practice Location Address
First Line	:	1329 WINTER GARDEN VINELAND RD STE 110
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-4353
Country	:	US
Telephone Number	:	321-800-3770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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