Basic Information
Provider Information
NPI: 1447562095
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALENCIA
FirstName: RIA MONICA
MiddleName: RIGOR
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 37174
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212973174
CountryCode: US
TelephoneNumber: 5714235699
FaxNumber: 5714235698
Practice Location
Address1: 2800 S SHIRLINGTON RD STE 706
Address2:  
City: ARLINGTON
State: VA
PostalCode: 222063602
CountryCode: US
TelephoneNumber: 5717772350
FaxNumber: 5717772331
Other Information
ProviderEnumerationDate: 07/12/2010
LastUpdateDate: 10/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD162201ORN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000XMT197698PAN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X0101272287VAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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