Provider Demographics
NPI:1033295506
Name:KILBY, MARIA LIZA FLORES (MD)
Entity type:Individual
Prefix:
First Name:MARIA LIZA
Middle Name:FLORES
Last Name:KILBY
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 1:509 HIGHGATE TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6314
Mailing Address - Country:US
Mailing Address - Phone:301-384-3311
Mailing Address - Fax:
Practice Address - Street 1:7676 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 220A
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-7512
Practice Address - Country:US
Practice Address - Phone:301-431-2973
Practice Address - Fax:301-439-0008
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055224208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD488001300Medicaid
MDDOO55224OtherMD MEDICAL LICENSE