Healthcare Provider Details

I. General information

NPI: 1881867646
Provider Name (Legal Business Name): SILVIA NATALIA JAIMES OCAZIONEZ M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 S JEFFERSON ST STE 106
ROANOKE VA
24016-4418
US

IV. Provider business mailing address

1030 S JEFFERSON ST STE 106
ROANOKE VA
24016-4418
US

V. Phone/Fax

Practice location:
  • Phone: 540-985-8230
  • Fax: 540-343-1012
Mailing address:
  • Phone: 540-985-8230
  • Fax: 540-343-1012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2007-01195
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101255477
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: