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General NPI Number Information
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NPI Number | 1093313652
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Entity Type | Organization
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Legal Business Name | HISPANIC AMERICAN PEDIATRICS & FAMILY CARE LLC
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 2255 CRAIN HWY STE 107
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City | WALDORF
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State | MD
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Zip | 20601-3186
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Country | US
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Telephone | 301-818-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 2255 CRAIN HWY STE 107
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City | WALDORF
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State | MD
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Zip | 20601-3186
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Country | US
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Telephone | 301-818-7272
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Fax |
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Authorized Official
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Title or Position | CRNP
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Name | MRS. LETICIA GRACIELA BUSTAMANTE SANCHEZ
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Credential | NURSE PRACTITIONER
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Telephone | 301-818-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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