Healthcare Provider Details

I. General information

NPI: 1609857713
Provider Name (Legal Business Name): ZENEN C LIMBO-PEREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 24TH ST KENNER ARMY HEALTH CLINIC
FORT LEE VA
23801-1716
US

IV. Provider business mailing address

700 24TH ST KENNER ARMY HEALTH CLINIC
FORT LEE VA
23801-1716
US

V. Phone/Fax

Practice location:
  • Phone: 804-734-9125
  • Fax: 804-734-9011
Mailing address:
  • Phone: 804-734-9125
  • Fax: 804-734-9011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1003X
TaxonomyIndependent Duty Medical Technicians
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: