Basic Information
| Provider Information | |||||||||
| NPI: | 1962703652 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALOMINO GUILLEN | ||||||||
| FirstName: | PAOLA | ||||||||
| MiddleName: | MILAGROS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 549 E. BRAMBLETON AVE | ||||||||
| Address2: | JENCARE NEIGHBORHOOD MEDICAL NORFOLK, LLC | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575339441 | ||||||||
| FaxNumber: | 7574461454 | ||||||||
| Practice Location | |||||||||
| Address1: | 549 E. BRAMBLETON AVE | ||||||||
| Address2: | JENCARE NEIGHBORHOOD MEDICAL NORFOLK, LLC | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575339441 | ||||||||
| FaxNumber: | 7574461454 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2010 | ||||||||
| LastUpdateDate: | 01/26/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35.125277 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 0101259423 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.