=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881867646
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SILVIA NATALIA JAIMES OCAZIONEZ M.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2008
-----------------------------------------------------
Last Update Date | 01/15/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1030 S JEFFERSON ST STE 106
-----------------------------------------------------
City | ROANOKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24016-4418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-985-8230
-----------------------------------------------------
Fax | 540-343-1012
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1030 S JEFFERSON ST STE 106
-----------------------------------------------------
City | ROANOKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24016-4418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-985-8230
-----------------------------------------------------
Fax | 540-343-1012
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 2007-01195
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 0101255477
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------