Healthcare Provider Details

I. General information

NPI: 1124958236
Provider Name (Legal Business Name): RUBIA ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13947 RICHMOND HWY
WOODBRIDGE VA
22191-2010
US

IV. Provider business mailing address

15212 COLORADO AVE
WOODBRIDGE VA
22191-3729
US

V. Phone/Fax

Practice location:
  • Phone: 703-493-0663
  • Fax: 703-493-0663
Mailing address:
  • Phone: 703-493-0663
  • Fax: 703-221-2570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: