MEDICARE: ZORAYDA M LEE-LLACER M.D.

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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	D0012962	MD
2	207L00000X	Anesthesiology Physician	D0012962	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	66770001	OTHER		CAREFIRST

General Provider Information

NPI Number	:	1679577092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZORAYDA M LEE-LLACER M.D.

Provider Business Mailing Address
First Line	:	8909 OLD BRANCH AVE
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-2528
Country	:	US
Telephone Number	:	301-868-7274
Fax Number	:	301-868-9098

Provider Business Practice Location Address
First Line	:	818 BAYSIDE DR
Second Line	:
City	:	STEVENSVILLE
State	:	MD
Zip	:	21666-2734
Country	:	US
Telephone Number	:	202-239-5888
Fax Number	:	301-868-9098

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	10/02/2024

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