Active NPI
Fermina Liza Roman, LMHC
- Psychologist
- Riverview, FL
National Provider Identifier
1922339787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY11562
- Practice address
- 11327 Village Brook Drive
Riverview, FL 33579 - Phone
- (813) 278-7644
- NPI assigned
- Jan 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY11562 | FL | Primary |
Addresses
Primary practice location
11327 Village Brook Drive
Riverview, FL 33579
Mailing address
PO Box 615
Lares, PR 00669-0615
Phone (787) 452-7173
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
125 N Moon Ave
Suite C
Brandon, FL 33510-4431
Phone (813) 278-7644
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY11562 | FL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Latino Kids and Family Mental Health LLC | Mental Health | Current | Accepting new patients |
Locations
125 N Moon Ave
Ste C
Brandon, FL 33510
Phone (813) 278-7644
Networks
- Freedom Health HMO Network
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Riverview, FL
- NPI 1972104420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660694400000",
"number": "1922339787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 615",
"city": "LARES",
"state": "PR",
"postal_code": "006690615",
"telephone_number": "787-452-7173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11327 VILLAGE BROOK DRIVE",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "33579",
"telephone_number": "813-278-7644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "FERMINA",
"middle_name": "LIZA",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-19",
"last_updated": "2022-08-17",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "FL",
"license": "PY11562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.