Healthcare Provider Details

I. General information

NPI: 1770420705
Provider Name (Legal Business Name): DARYSA GREGORY NARANJO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14235 PARK CENTER DR
LAUREL MD
20707-5261
US

IV. Provider business mailing address

PO BOX 500
BROOKEVILLE MD
20833-0500
US

V. Phone/Fax

Practice location:
  • Phone: 301-498-8100
  • Fax:
Mailing address:
  • Phone: 301-498-8100
  • Fax: 301-498-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: