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Individual

DR. JORGE RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
12359 SUNRISE VALLEY DR, SUITE #220, RESTON, VA 20191-3462
(703) 476-9500
Mailing address
12359 SUNRISE VALLEY DR, SUITE #220, RESTON, VA 20191-3462
(703) 476-9500

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1230161
UHC UBH
VA
01
283186
AMERIGROUP
VA
01
334206
ANTHEM
VA
01
46810001
CF BCBS DC
DC
Enumeration date
11/09/2006
Last updated
12/05/2007
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