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1679078083 NPI number — GEORGINA MARIA MEDINA AGRAMONTE MD

NPI Number: 1679078083
Health Care Provider/Practitioner: GEORGINA MARIA MEDINA AGRAMONTE MD

Information about “1679078083” NPI (GEORGINA MARIA MEDINA AGRAMONTE MD) exists in 1679078083 in HTML format HTML  |  1679078083 in plain Text format TXT  |  1679078083 in PDF (Portable Document Format) PDF  |  1679078083 in an XML format XML  formats.

NPI Number : 1679078083 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679078083",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MEDINA AGRAMONTE",
    "FirstName": "GEORGINA",
    "MiddleName": "MARIA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MEDINA",
    "OtherFirstName": "GEORGINA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "11300 ROCKVILLE PIKE STE 1202",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROCKVILLE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "20852-3040",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "301-896-0890",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4301 CONNECTICUT AVE NW STE 125",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WASHINGTON",
    "PracticeLocationAddressStateName": "DC",
    "PracticeLocationAddressPostalCode": "20008-2332",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "301-896-0890",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/27/2018",
    "LastUpdateDate": "03/05/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": "D0098211",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": "MD210012408",
          "LicenseNumberStateCode": "DC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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