MEDICARE: BRYNDA MELIEGO SAMO

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1518737709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYNDA MELIEGO SAMO

Provider Business Mailing Address
First Line	:	14101 CASTLE BLVD APT 103
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-4725
Country	:	US
Telephone Number	:	301-675-7920
Fax Number	:

Provider Business Practice Location Address
First Line	:	14101 CASTLE BLVD APT 103
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-4725
Country	:	US
Telephone Number	:	301-675-7920
Fax Number	:

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

Provider Enumeration Date	:	01/08/2024
Last Update Date	:	01/08/2024

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Directions to “ BRYNDA MELIEGO SAMO ” Practice Location

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