Provider Demographics
NPI:1255371738
Name:VILORIA-GRAGEDA, MARILES (MD)
Entity type:Individual
Prefix:DR
First Name:MARILES
Middle Name:
Last Name:VILORIA-GRAGEDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 RICHMOND HWY STE 110
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-1850
Mailing Address - Country:US
Mailing Address - Phone:703-660-8100
Mailing Address - Fax:703-768-0103
Practice Address - Street 1:1730 RHODE ISLAND AVE NW STE 502
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3117
Practice Address - Country:US
Practice Address - Phone:202-902-7324
Practice Address - Fax:848-213-0063
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD6000031292084P0800X
VA01012652332084P0800X
MDD00575712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD808400900Medicaid
MD260046906OtherR/R MEDICARE PROVIDER #