Healthcare Provider Details

I. General information

NPI: 1952003915
Provider Name (Legal Business Name): ALEXIA TREVINO QUIROGA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19465 DEERFIELD AVE STE 410
LANSDOWNE VA
20176-1708
US

IV. Provider business mailing address

43003 GOLF VIEW DR
CHANTILLY VA
20152-2001
US

V. Phone/Fax

Practice location:
  • Phone: 571-206-8696
  • Fax:
Mailing address:
  • Phone: 571-594-9708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101289576
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: