Provider Demographics
NPI:1366923716
Name:PAZ SOLDAN, ROSA JACQUELINE
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:JACQUELINE
Last Name:PAZ SOLDAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22004 BOX CAR SQ
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-3039
Mailing Address - Country:US
Mailing Address - Phone:703-203-9635
Mailing Address - Fax:
Practice Address - Street 1:4201 CATHEDRAL AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4901
Practice Address - Country:US
Practice Address - Phone:703-203-9635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant