Provider Demographics
NPI:1003320029
Name:RODRIGUEZ-DAVILA, PAOLA A
Entity Type:Individual
Prefix:MISS
First Name:PAOLA
Middle Name:A
Last Name:RODRIGUEZ-DAVILA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:PAOLA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:904 PRINCESS ANNE ST STE 301&402
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5801
Mailing Address - Country:US
Mailing Address - Phone:540-322-2289
Mailing Address - Fax:540-479-3282
Practice Address - Street 1:904 PRINCESS ANNE ST STE 402
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5804
Practice Address - Country:US
Practice Address - Phone:540-322-2289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program