MEDICARE: SYRABELL LLC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1275392219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYRABELL LLC

Provider Business Mailing Address
First Line	:	9079 FOX STREAM WAY
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-2557
Country	:	US
Telephone Number	:	202-221-1234
Fax Number	:

Provider Business Practice Location Address
First Line	:	9079 FOX STREAM WAY
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-2557
Country	:	US
Telephone Number	:	202-221-1234
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MISS BASIRATU BELLO
Credential	:	NP
Telephone Number	:	202-221-1234

Provider Enumeration Date	:	03/13/2024
Last Update Date	:	03/13/2024

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Directions to “SYRABELL LLC ” Practice Location

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