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General NPI Number Information
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NPI Number | 1083427397
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Entity Type | Individual
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Provider Name | ROBERT EDGARDO VARGAS VIZCAYA
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Gender | Male
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 5601 SEMINARY RD
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3530
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Country | US
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Telephone | 614-928-0409
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Fax |
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Provider Business Mailing Address
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Address Line | 5601 SEMINARY RD
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3530
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Country | US
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Telephone | 614-928-0409
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | SA2000005
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 0136000746
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License Number State | VA
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