| Ingrid Roman Psyd Pa | |
|
2030 S Douglas Rd Ste 215 Coral Gables FL 33134-4620 | |
| (305) 661-5511 | |
| Not Available |
| Full Name | Ingrid Roman Psyd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 2030 S Douglas Rd Ste 215, Coral Gables, Florida |
| Authorized Official Name and Position | Ingrid Roman (PSYD) |
| Authorized Official Contact | 7862051741 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingrid Roman Psyd Pa 7950 W Flagler St Suite 105 Miami FL 33144-2206 Ph: (305) 661-5511 | Ingrid Roman Psyd Pa 2030 S Douglas Rd Ste 215 Coral Gables FL 33134-4620 Ph: (305) 661-5511 |
| NPI Number | 1679908164 |
|---|---|
| Provider Enumeration Date | 09/04/2013 |
| Last Update Date | 10/16/2023 |
| Certification Date | 10/16/2023 |
| Medicare PECOS PAC ID | 1254567514 |
|---|---|
| Medicare Enrollment ID | O20131115001100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679908164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY8783 (Florida) | Primary |
| Provider Name | Ingrid Roman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174957914 PECOS PAC ID: 5799911053 Enrollment ID: I20140102001533 |
| Provider Name | Lyllymar Colon Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720683345 PECOS PAC ID: 5890195515 Enrollment ID: I20210616002273 |
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