Provider Demographics
NPI:1902016843
Name:ROMANO, DAVID J (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:ROMANO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 LEE RD
Mailing Address - Street 2:SUITE 217-A
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1859
Mailing Address - Country:US
Mailing Address - Phone:407-628-0504
Mailing Address - Fax:
Practice Address - Street 1:1950 LEE RD
Practice Address - Street 2:SUITE 217-A
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1859
Practice Address - Country:US
Practice Address - Phone:407-628-0504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 5067103T00000X
MD2091103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist