MEDICARE: ELAINE VILORIA SA-C

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	246ZC0007X	Surgical Assistant	SA0141	DC

General Provider Information

NPI Number	:	1760882047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE VILORIA SA-C

Provider Business Mailing Address
First Line	:	12011 LEE JACKSON HWY STE 501
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-3315
Country	:	US
Telephone Number	:	703-259-7027
Fax Number	:

Provider Business Practice Location Address
First Line	:	12011 LEE JACKSON HWY STE 501
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-3315
Country	:	US
Telephone Number	:	703-259-7027
Fax Number	:

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

Provider Enumeration Date	:	08/24/2014
Last Update Date	:	12/13/2018

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Directions to “ ELAINE VILORIA SA-C” Practice Location

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