Healthcare Provider Details

I. General information

NPI: 1316341753
Provider Name (Legal Business Name): JULIANA BUENDIA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 WALKER LN STE 507
ALEXANDRIA VA
22310-3251
US

IV. Provider business mailing address

6355 WALKER LN STE 507
ALEXANDRIA VA
22310-3251
US

V. Phone/Fax

Practice location:
  • Phone: 703-738-4332
  • Fax: 703-971-4605
Mailing address:
  • Phone: 703-738-4332
  • Fax: 703-971-4605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110006701
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: