Provider Demographics
NPI:1609857713
Name:LIMBO-PEREZ, ZENEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:ZENEN
Middle Name:C
Last Name:LIMBO-PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 24TH ST
Mailing Address - Street 2:KENNER ARMY HEALTH CLINIC
Mailing Address - City:FORT LEE
Mailing Address - State:VA
Mailing Address - Zip Code:23801-1716
Mailing Address - Country:US
Mailing Address - Phone:804-734-9125
Mailing Address - Fax:804-734-9011
Practice Address - Street 1:700 24TH ST
Practice Address - Street 2:KENNER ARMY HEALTH CLINIC
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1716
Practice Address - Country:US
Practice Address - Phone:804-734-9125
Practice Address - Fax:804-734-9011
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1710I1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101026159OtherMEDICAL LICENSE