Organization
ROMALDO DESOUZA, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA ROLLINS (BILLING MANAGER)
(410) 719-0020
Entity
Organization
Contact information
Practice address
6344 TRED AVON PLACE, GAINESVILLE, VA 20155-3133
(703) 217-6255
Mailing address
6344 TRED AVON PLACE, GAINESVILLE, VA 20155-3133
(703) 217-6255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740628007
—
VA
Enumeration date
12/10/2021
Last updated
12/10/2021
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