Healthcare Provider Details

I. General information

NPI: 1306423801
Provider Name (Legal Business Name): MARIA CAMILA ESPINAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 04/14/2024
Certification Date: 04/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 WALKER LN STE 401
ALEXANDRIA VA
22310-3250
US

IV. Provider business mailing address

625 MONROE ST NE APT 331
WASHINGTON DC
20017-1781
US

V. Phone/Fax

Practice location:
  • Phone: 703-924-2100
  • Fax: 703-922-6067
Mailing address:
  • Phone: 305-807-9013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101281692
License Number StateVA
# 2
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: