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NPI Code Detail

MEDICARE: MICHAEL ANTHONY CARRILLO

MEDICARE: MICHAEL ANTHONY CARRILLO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianMD-10274122785MD

General Provider Information

NPI Number : 1518899335
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ANTHONY CARRILLO
Provider Business Mailing Address
First Line : 13322 DOVEDALE WAY APT J
Second Line :
City : GERMANTOWN
State : MD
Zip : 20874-4479
Country : US
Telephone Number : 202-441-2564
Fax Number :
Provider Business Practice Location Address
First Line : 10490 LITTLE PATUXENT PKWY STE 600
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-4941
Country : US
Telephone Number : 667-447-7868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ MICHAEL ANTHONY CARRILLO ” Practice Location

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