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General NPI Number Information
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NPI Number | 1205435328
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Entity Type | Organization
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Legal Business Name | DAYDREAM SUNSHINE INITIATIVE
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 4000 MITCHELLVILLE RD STE A406
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City | BOWIE
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State | MD
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Zip | 20716-3139
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Country | US
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Telephone | 301-262-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 MITCHELLVILLE RD STE A404
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City | BOWIE
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State | MD
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Zip | 20716-3137
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Country | US
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Telephone | 301-262-0400
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Fax |
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | JENNIFER HERNANDEZ
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Credential |
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Telephone | 980-989-9487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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