Healthcare Provider Details

I. General information

NPI: 1225339658
Provider Name (Legal Business Name): MARIA SPIRITOSANTO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 LOISDALE COURT
SPRINGFIELD VA
22150-1885
US

IV. Provider business mailing address

2101 E JEFFERSON ST
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 703-922-1664
  • Fax:
Mailing address:
  • Phone: 301-816-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0001060087
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: