Provider Demographics
NPI:1316187859
Name:ILEANA M ESPARRAGUERA MD PC
Entity Type:Organization
Organization Name:ILEANA M ESPARRAGUERA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ILEANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ESPARRAGUERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-659-2600
Mailing Address - Street 1:2440 M STREET NW
Mailing Address - Street 2:SUITE 508
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1463
Mailing Address - Country:US
Mailing Address - Phone:202-659-2600
Mailing Address - Fax:202-659-2605
Practice Address - Street 1:2440 M STREET NW
Practice Address - Street 2:SUITE 508
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1463
Practice Address - Country:US
Practice Address - Phone:202-659-2600
Practice Address - Fax:202-659-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD30028208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC150652Medicare PIN