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1447528328
CARLOS FAGBENRO
MANASSAS, VA
NPI
1447528328
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: VA 0024169586)
Enumeration Date
2011-12-07
Last Update Date
2017-01-27
Business Address
Mr. CARLOS FAGBENRO NP
6360 HOADLY RD
MANASSAS, VA 20112-3422
Phone number: 571-594-9110
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Mailing Address
Mr. CARLOS FAGBENRO NP
15337 LORD CULPEPER CT
WOODBRIDGE, VA 22191-4937
Phone number: 571-594-9110
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