Healthcare Provider Details

I. General information

NPI: 1043131691
Provider Name (Legal Business Name): EUNICE TUCIO JARANDILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19801 OBSERVATION DR
GERMANTOWN MD
20876-4070
US

IV. Provider business mailing address

18920 MARSH HAWK LN
GAITHERSBURG MD
20879-1774
US

V. Phone/Fax

Practice location:
  • Phone: 301-557-6000
  • Fax:
Mailing address:
  • Phone: 520-989-4062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR243485
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: