Healthcare Provider Details

I. General information

NPI: 1275541013
Provider Name (Legal Business Name): CAPITAL PALLIATIVE CARE CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 FAIRVIEW PARK DRIVE SUITE 500
FALLS CHURCH VA
22042-4516
US

IV. Provider business mailing address

3180 FAIRVIEW PARK DRIVE SUITE 500
FALLS CHURCH VA
22042-4516
US

V. Phone/Fax

Practice location:
  • Phone: 703-538-2043
  • Fax: 703-852-7389
Mailing address:
  • Phone: 703-538-2043
  • Fax: 703-852-7389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL BUCCIARELLI
Title or Position: VP, LEGAL SERVICES
Credential:
Phone: 813-871-8075