Basic Information
| Provider Information | |||||||||
| NPI: | 1881930253 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARLINGTON PEDIATRIC CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 S CARLIN SPRINGS RD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222041044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032718800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 S CARLIN SPRINGS RD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222041044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032718800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2012 | ||||||||
| LastUpdateDate: | 12/12/2012 | ||||||||
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| AuthorizedOfficialLastName: | PAZ-SOLDAN | ||||||||
| AuthorizedOfficialFirstName: | GONZALO | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7032718109 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 0904001756 | VA | N | Ambulatory Health Care Facilities | Clinic/Center | 261QM0855X | 0904001756 | VA | Y | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No ID Information.