Provider Demographics
NPI:1295945830
Name:VELANDIA RUBIANO, BERTHA CECILIA (MD)
Entity type:Individual
Prefix:
First Name:BERTHA
Middle Name:CECILIA
Last Name:VELANDIA RUBIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10801 LOCKWOOD DR STE 160
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1586
Mailing Address - Country:US
Mailing Address - Phone:301-298-1040
Mailing Address - Fax:
Practice Address - Street 1:800 S FREDERICK AVE STE 110
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4151
Practice Address - Country:US
Practice Address - Phone:301-208-2273
Practice Address - Fax:855-313-1249
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN44974207Q00000X
MDD0077073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine