Individual
BEVERLY FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14801 LYNHODGE CT, CENTREVILLE, VA 20120-1863
(786) 230-7336
Mailing address
14801 LYNHODGE CT, CENTREVILLE, VA 20120-1863
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0024197060
VA
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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