Provider Demographics
NPI:1205078425
Name:FIGUEROA, VICENTE (MD)
Entity type:Individual
Prefix:
First Name:VICENTE
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1311
Mailing Address - Country:US
Mailing Address - Phone:301-221-2090
Mailing Address - Fax:240-892-0192
Practice Address - Street 1:932 HUNGERFORD DR
Practice Address - Street 2:SUITE 1-A
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6155
Practice Address - Country:US
Practice Address - Phone:301-221-2090
Practice Address - Fax:240-892-0192
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00315822084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD435231900Medicaid