Healthcare Provider Details

I. General information

NPI: 1811293749
Provider Name (Legal Business Name): AMELIA ROSALITA SESMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 HOPE LN
GAITHERSBURG MD
20878-1883
US

IV. Provider business mailing address

710 HOPE LN
GAITHERSBURG MD
20878-1883
US

V. Phone/Fax

Practice location:
  • Phone: 301-412-4023
  • Fax:
Mailing address:
  • Phone: 301-412-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: