Provider Demographics
NPI:1821856287
Name:ROMANO, JESSICA JEWEL (RN, IBCLC, RNC-MNN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JEWEL
Last Name:ROMANO
Suffix:
Gender:F
Credentials:RN, IBCLC, RNC-MNN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 E GRANT ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-5101
Mailing Address - Country:US
Mailing Address - Phone:407-490-7008
Mailing Address - Fax:
Practice Address - Street 1:3805 E GRANT ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-5101
Practice Address - Country:US
Practice Address - Phone:407-490-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-311234163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant