| Doctor Name: | DR. JORGE A. CAPO-RODRIGUEZ |
| NPI Number: | 1447564133 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 0101252942 |
| Business Practice Address: | 202 Agee Street Farmville, VA - 239012617 |
| Business Phone Number: | 4343926143 |
| Business Fax Number: | 4343923866 |
| Mailing Address: | 202 Agee Street, FARMVILLE |
| State: | VA |
| Postal Code: | 239012617 |
| Phone Number: | 4343926143 |
| Fax Number: | 4343923866 |
| NPI Enumeration Date: | 08/05/2010 |
| NPI Last Update Date: | 12/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101252942 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |