MEDICARE: MARIA ALEXANDRIA RAMIREZ PT

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	225100000X	Physical Therapist	2305203608	VA

General Provider Information

NPI Number	:	1538161286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ALEXANDRIA RAMIREZ PT

Provider Business Mailing Address
First Line	:	9900 MAIN ST
Second Line	:	SUITE 200A
City	:	FAIRFAX
State	:	VA
Zip	:	22031-3907
Country	:	US
Telephone Number	:	703-279-4394
Fax Number	:	703-279-4214

Provider Business Practice Location Address
First Line	:	8101 HINSON FARM RD
Second Line	:	SUITE 108
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3403
Country	:	US
Telephone Number	:	703-664-7660
Fax Number	:	703-664-7663

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	07/08/2007

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