Healthcare Provider Details

I. General information

NPI: 1912971656
Provider Name (Legal Business Name): SERGIO ROMEO RIMOLA M.D., F.A.C.O.G.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SERGIO ROMEO RIMOLA M.D., F.A.C.O.G

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3300
US

IV. Provider business mailing address

1082 METHVEN CT
HERNDON VA
20170-2353
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-4001
  • Fax: 703-776-7113
Mailing address:
  • Phone: 703-421-8629
  • Fax: 703-448-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101056587
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: