Individual
DR. LISSETTE CARMONA-ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
521 BRUNSWICK DR, DAVENPORT, FL 33837-4609
(347) 480-6490
Mailing address
521 BRUNSWICK DR, DAVENPORT, FL 33837-4609
(347) 480-6490
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3509
PR
103T00000X
Psychologist
Primary
PY11323
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2010
Last updated
11/14/2022
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