MEDICARE: DR. JORGE I RAMALLO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	0101259926	VA

General Provider Information

NPI Number	:	1811250293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE I RAMALLO M.D.

Provider Business Mailing Address
First Line	:	4216 EVERGREEN LN STE 121
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-3256
Country	:	US
Telephone Number	:	703-434-0749
Fax Number	:	888-671-8837

Provider Business Practice Location Address
First Line	:	4216 EVERGREEN LN STE 121
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-3256
Country	:	US
Telephone Number	:	703-434-0749
Fax Number	:	888-671-8837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2012
Last Update Date	:	10/22/2025

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