Individual
MR. RODOLFO BAYLE OCAMPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
701 E CHARLES ST, CIVISTA MEDICAL CENTER, LA PLATA, MD 20646-9581
(301) 609-4152
Mailing address
1310 REDWOOD CIR, LA PLATA, MD 20646-9581
(301) 934-8738
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R064594
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430051194
MEDICARE RAILROAD
—
05
—
699300100
—
MD
Enumeration date
01/16/2007
Last updated
07/27/2009
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