Provider Demographics
NPI:1134242399
Name:ESPINA, MARIA ELENA MARCOS (PA-C)
Entity type:Individual
Prefix:
First Name:MARIA ELENA
Middle Name:MARCOS
Last Name:ESPINA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARLENE
Other - Middle Name:
Other - Last Name:ESPINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18109 PRINCE PHILIP DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1519
Mailing Address - Country:US
Mailing Address - Phone:301-570-7203
Mailing Address - Fax:301-570-8556
Practice Address - Street 1:18109 PRINCE PHILIP DR
Practice Address - Street 2:SUITE 300
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1519
Practice Address - Country:US
Practice Address - Phone:301-570-7203
Practice Address - Fax:301-570-8556
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001066363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical