Provider Demographics
NPI:1912971656
Name:RIMOLA, SERGIO ROMEO (MD, FACOG)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:ROMEO
Last Name:RIMOLA
Suffix:
Gender:M
Credentials:MD, FACOG
Other - Prefix:DR
Other - First Name:SERGIO
Other - Middle Name:ROMEO
Other - Last Name:RIMOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, FACOG
Mailing Address - Street 1:1082 METHVEN CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2353
Mailing Address - Country:US
Mailing Address - Phone:703-421-8629
Mailing Address - Fax:703-448-9141
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3300
Practice Address - Country:US
Practice Address - Phone:703-776-4001
Practice Address - Fax:703-776-7113
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056587174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010298849Medicaid
E77488Medicare UPIN