Healthcare Provider Details

I. General information

NPI: 1669915146
Provider Name (Legal Business Name): VICENTE FIGUEROA MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2016
Last Update Date: 12/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 HUNGERFORD DR SUITE 1-A
ROCKVILLE MD
20850-1713
US

IV. Provider business mailing address

308 1ST ST
ROCKVILLE MD
20851-1311
US

V. Phone/Fax

Practice location:
  • Phone: 301-221-2090
  • Fax: 240-892-0192
Mailing address:
  • Phone: 301-219-1614
  • Fax: 240-892-0192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0031582
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0031582
License Number StateMD

VIII. Authorized Official

Name: DR. VICENTE FIGUEROA
Title or Position: OWNER
Credential: M.D.
Phone: 301-219-1614