Healthcare Provider Details

I. General information

NPI: 1033072103
Provider Name (Legal Business Name): PRM GYNECOLOGY OF VIRGINIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 ARLINGTON BLVD STE 404
FALLS CHURCH VA
22042-3000
US

IV. Provider business mailing address

2090 PALM BEACH LAKES BLVD STE 700
WEST PALM BEACH FL
33409-6508
US

V. Phone/Fax

Practice location:
  • Phone: 703-637-3282
  • Fax:
Mailing address:
  • Phone: 561-422-4206
  • Fax: 561-422-4206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JANE LAGNESE JANE LAGNESE
Title or Position: DIRECTOR RCM
Credential:
Phone: 561-422-4206