Basic Information
| Provider Information | |||||||||
| NPI: | 1932254620 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SERGIO R. RIMOLA, M.D. PLLC | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 8302 OLD COURTHOUSE RD STE A | ||||||||
| Address2: | |||||||||
| City: | VIENNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221823873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034489140 | ||||||||
| FaxNumber: | 7034489141 | ||||||||
| Practice Location | |||||||||
| Address1: | 8302 OLD COURTHOUSE RD STE A | ||||||||
| Address2: | |||||||||
| City: | VIENNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221823873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034489140 | ||||||||
| FaxNumber: | 7034489141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | RIMOLA | ||||||||
| AuthorizedOfficialFirstName: | SERGIO | ||||||||
| AuthorizedOfficialMiddleName: | ROMEO | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICIER | ||||||||
| AuthorizedOfficialTelephone: | 7034489140 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 0101056587 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.