Provider Demographics
NPI:1932254620
Name:SERGIO R. RIMOLA, M.D. PLLC
Entity Type:Organization
Organization Name:SERGIO R. RIMOLA, M.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICIER
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:ROMEO
Authorized Official - Last Name:RIMOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-448-9140
Mailing Address - Street 1:8302 OLD COURTHOUSE RD STE A
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3873
Mailing Address - Country:US
Mailing Address - Phone:703-448-9140
Mailing Address - Fax:703-448-9141
Practice Address - Street 1:8302 OLD COURTHOUSE RD STE A
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3873
Practice Address - Country:US
Practice Address - Phone:703-448-9140
Practice Address - Fax:703-448-9141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056587174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty