Provider Demographics
NPI:1225242670
Name:ACEVEDO SANTANA, YLIANA M (MD,MPH)
Entity Type:Individual
Prefix:
First Name:YLIANA
Middle Name:M
Last Name:ACEVEDO SANTANA
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:
Other - First Name:YLIANA
Other - Middle Name:M
Other - Last Name:ACEVEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:224D CORNWALL ST NW STE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6001
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:44084 RIVERSIDE PARKWAY, SUITE 300
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5102
Practice Address - Country:US
Practice Address - Phone:703-724-7530
Practice Address - Fax:703-858-2870
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241483207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1225242670Medicaid
VA1225242670Medicaid