Provider Demographics
NPI:1326791179
Name:LARIOS DE UMANZOR, ROSA NELIA
Entity Type:Individual
Prefix:MS
First Name:ROSA NELIA
Middle Name:
Last Name:LARIOS DE UMANZOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12813 CRISFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-4031
Mailing Address - Country:US
Mailing Address - Phone:240-393-7014
Mailing Address - Fax:
Practice Address - Street 1:5074 G ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5901
Practice Address - Country:US
Practice Address - Phone:202-246-9627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant