Provider Demographics
NPI:1083506075
Name:VIANA RODRIGUEZ, GRACIA MARIA
Entity type:Individual
Prefix:
First Name:GRACIA
Middle Name:MARIA
Last Name:VIANA RODRIGUEZ
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CENTER DR BLDG 10
Mailing Address - Street 2:RM 5-2740NW
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0004
Mailing Address - Country:US
Mailing Address - Phone:301-496-1721
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DR BLDG 10
Practice Address - Street 2:RM 5-2740NW
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0004
Practice Address - Country:US
Practice Address - Phone:301-496-1721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1346775434207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine