Individual provider · NPI-1

Xiomara I Fuentes

Student in an Organized Health Care Education/Training Program · Bowie, MD

NPI number1336018910
StatusActive
Last updated in NPPESNov 3, 2025

Details

NPI
1336018910
Entity type
Individual (NPI-1)
Name
Xiomara I Fuentes
Sex
Female
Sole proprietor
No
Enumeration date
Nov 3, 2025
Certification date
Nov 3, 2025
Last updated
Nov 3, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program–MDYes

Practice location

12158 Central Ave
Bowie, MD 20721-1932

Phone 301-390-3076

Mailing address

4209 74th Pl
Hyattsville, MD 20784-2305

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