Healthcare Provider Details

I. General information

NPI: 1619532793
Provider Name (Legal Business Name): SOFIA MARIA SAAVEDRA-COLLADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2019
Last Update Date: 05/14/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 VOLVO PKWY
CHESAPEAKE VA
23320-2855
US

IV. Provider business mailing address

2781 TAIT TER
NORFOLK VA
23509-2349
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-4630
  • Fax: 757-668-4635
Mailing address:
  • Phone: 757-663-1645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101285189
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: