Provider Demographics
NPI:1962703652
Name:PALOMINO GUILLEN, PAOLA MILAGROS (MD)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:MILAGROS
Last Name:PALOMINO GUILLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 E. BRAMBLETON AVE
Mailing Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL NORFOLK, LLC
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510
Mailing Address - Country:US
Mailing Address - Phone:757-533-9441
Mailing Address - Fax:757-446-1454
Practice Address - Street 1:549 E. BRAMBLETON AVE
Practice Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL NORFOLK, LLC
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:757-533-9441
Practice Address - Fax:757-446-1454
Is Sole Proprietor?:No
Enumeration Date:2010-11-11
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125277207R00000X
390200000X
VA0101259423207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program