Healthcare Provider Details

I. General information

NPI: 1184437154
Provider Name (Legal Business Name): ROLANDO ALFREDO DEL AGUILA SUAREZ FNP, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 NORWAY PL
NORFOLK VA
23509-1299
US

IV. Provider business mailing address

3419 NORWAY PL
NORFOLK VA
23509-1299
US

V. Phone/Fax

Practice location:
  • Phone: 252-543-9809
  • Fax: 757-484-3810
Mailing address:
  • Phone: 252-543-9809
  • Fax: 757-484-3810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024192457
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: