Individual
DR. JOSE LEONARDO ROSALES SIOCO III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8109 TIS WELL DRIVE, SUITE 511, ALEXANDRIA, VA 22306
(703) 799-9500
(703) 799-9502
Mailing address
PO BOX 37189, BALTIMORE, MD 21297-3189
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101272474
VA
207Q00000X
Family Medicine Physician
MD162200
OR
Other
Enumeration date
07/12/2010
Last updated
08/23/2021
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