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General NPI Number Information
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NPI Number | 1619147717
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Entity Type | Organization
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Legal Business Name | PLASTIC SURGERY SPECIALIST OF VIRGINIA, INC.
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 5131 RIVER CLUB DR STE 110
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City | SUFFOLK
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State | VA
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Zip | 23435-3846
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Country | US
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Telephone | 757-483-6550
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Fax | 757-483-6555
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Provider Business Mailing Address
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Address Line | 5131 RIVER CLUB DR STE 110
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City | SUFFOLK
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State | VA
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Zip | 23435-3846
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Country | US
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Telephone | 757-483-6550
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Fax | 757-483-6555
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. HELENA M. GUARDA
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Credential | MD
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Telephone | 757-483-6550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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