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

General Provider Information

NPI Number	:	1952042129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTGOMERY COUNTY MARYLAND GOVERNMENT

Provider Business Mailing Address
First Line	:	101 MONROE ST
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-2503
Country	:	US
Telephone Number	:	240-777-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 RANDOLPH RD
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-1447
Country	:	US
Telephone Number	:	240-740-0115
Fax Number	:

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

Provider Enumeration Date	:	04/04/2022
Last Update Date	:	09/09/2025

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