Provider Demographics
NPI:1538694203
Name:PRZYBYLO, ALEXANDRA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ROSE
Last Name:PRZYBYLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEANDRA
Other - Middle Name:ROSE
Other - Last Name:CHICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11601 ROBIOUS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-5605
Mailing Address - Country:US
Mailing Address - Phone:804-379-9494
Mailing Address - Fax:
Practice Address - Street 1:11601 ROBIOUS RD STE 100
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-5605
Practice Address - Country:US
Practice Address - Phone:804-379-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101267575208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics