MEDICARE: AMBROISE EMBOLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1164780847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBROISE EMBOLO

Provider Business Mailing Address
First Line	:	8878 PINEY BRANCH RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-2705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2312 RHODE ISLAND AVE. NORTHEAST
Second Line	:	AQHCS
City	:	WASHINGTON
State	:	DC
Zip	:	20018
Country	:	US
Telephone Number	:	202-635-6006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2012
Last Update Date	:	02/15/2026

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Directions to “ AMBROISE EMBOLO ” Practice Location

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