Provider Demographics
NPI:1831410497
Name:LAMIRAND, THANIA VIOLETA (MD)
Entity type:Individual
Prefix:
First Name:THANIA
Middle Name:VIOLETA
Last Name:LAMIRAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:THANIA
Other - Middle Name:
Other - Last Name:MEDINA-ROJAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3022 WILLIAMS DR 300
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4600
Mailing Address - Country:US
Mailing Address - Phone:703-738-5713
Mailing Address - Fax:703-573-2959
Practice Address - Street 1:3022 WILLIAMS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4600
Practice Address - Country:US
Practice Address - Phone:703-573-9800
Practice Address - Fax:703-573-2959
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272038207P00000X
VA0101255214207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD517323ZDDBMedicare PIN
MD517323YVZMedicare PIN
VAVVL868AMedicare PIN
NYJ400122644/GRPBA0017Medicare PIN
VA457484YWAUMedicare PIN
MD457484YWV2Medicare PIN
NYJ400122643/GRP70008AMedicare PIN