Healthcare Provider Details

I. General information

NPI: 1588347025
Provider Name (Legal Business Name): JULIET I OGULEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 48TH ST NE
WASHINGTON DC
20019-3607
US

IV. Provider business mailing address

300 NATICK CT
SILVER SPRING MD
20905-5875
US

V. Phone/Fax

Practice location:
  • Phone: 202-541-9844
  • Fax:
Mailing address:
  • Phone: 240-491-2528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN65262
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: