Healthcare Provider Details

I. General information

NPI: 1225849078
Provider Name (Legal Business Name): INTERNATIONAL PEDIATRICS, P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 01/20/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N FREDERICK AVE STE 212
GAITHERSBURG MD
20877-2545
US

IV. Provider business mailing address

501 N FREDERICK AVE STE 212
GAITHERSBURG MD
20877-2545
US

V. Phone/Fax

Practice location:
  • Phone: 301-407-1597
  • Fax: 240-290-1045
Mailing address:
  • Phone: 301-407-1597
  • Fax: 240-290-1045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: REYNA CARTAGENA
Title or Position: OFFICER MANAGER
Credential:
Phone: 240-290-1041