# WARLITO G ROLLOLAZO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Center for General Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851419410
- **Authorized official:** WARLITO G ROLLOLAZO MD (OWNER)
- **Authorized official phone:** (770) 456-9993

## Contact information

- **Practice address:** 809 W BANKHEAD HWY, SUITE D, VILLA RICA, GA 30180-1520
- **Practice address phone:** (770) 456-9993
- **Practice address fax:** (770) 456-9949
- **Mailing address:** 809 W BANKHEAD HWY, SUITE D, VILLA RICA, GA 30180-1520
- **Mailing address phone:** (770) 456-9993
- **Mailing address fax:** (770) 456-9949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 17551 | GA | Yes |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 06/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000114133G | — | GA |
| 05 | — | 143087983A | — | GA |