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General NPI Number Information
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NPI Number | 1487038915
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Entity Type | Organization
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Legal Business Name | ORTEGA-RODRIGUEZ MEDICAL SERVICES , INC
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 3914 MEADOWDALE BLVD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23234-5547
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Country | US
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Telephone | 954-805-4121
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Fax |
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Provider Business Mailing Address
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Address Line | 11213 KINGFISHER TER
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-3148
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Country | US
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Telephone | 954-805-4121
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Fax |
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. PAOLA ANDREA ORTEGA RODRIGUEZ
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Credential | M.D
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Telephone | 954-805-4121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101258599
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License Number State | VA
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