Healthcare Provider Details

I. General information

NPI: 1548717051
Provider Name (Legal Business Name): MARIA ABRAXAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 CALIFORNIA CIR APT 413
ROCKVILLE MD
20852-4842
US

IV. Provider business mailing address

6030 CALIFORNIA CIRCLE APT 413
ROCKVILLE MD
20852
US

V. Phone/Fax

Practice location:
  • Phone: 240-476-8543
  • Fax:
Mailing address:
  • Phone: 240-476-8543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number07287
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: