MEDICARE: MONTGOMERY COUNTY MARYLAND GOVERNMENT

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	261QP0905X	State or Local Public Health Clinic/Center
2	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174759633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTGOMERY COUNTY MARYLAND GOVERNMENT

Provider Business Mailing Address
First Line	:	401 HUNGERFORD DR FL 6
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-4154
Country	:	US
Telephone Number	:	240-777-4520
Fax Number	:

Provider Business Practice Location Address
First Line	:	8720 CARROLL AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-3149
Country	:	US
Telephone Number	:	240-740-1570
Fax Number	:	301-431-6018

Authorized Official
Title or Position	:	MANAGEMENT
Name	:	DIANA AZUCENA CORTEZ
Credential	:
Telephone Number	:	240-672-6758

Provider Enumeration Date	:	06/10/2009
Last Update Date	:	01/20/2026

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