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NPI Profile for RUDOLFO S AGUSTIN JR in SUFFOLK, VA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Emergency |
163WE0003X |
| NPI # | 1114708138 |
|
| Status | Active | |
| Credentials | FNP-BC (Family Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 10/06/2023 | |
| Last updated | 10/06/2023 - About 3 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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RUDOLFO S AGUSTIN JR
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RUDOLFO S AGUSTIN JR, FNP-BC