Individual
JOSE LUIS PUEBLA-TARILONTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12004 AUTUMNWOOD LN, FORT WASHINGTON, MD 20744-6064
(301) 203-1543
Mailing address
12004 AUTUMNWOOD LN, FORT WASHINGTON, MD 20744-6064
(301) 203-1543
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
3770
PR
Other
Enumeration date
06/03/2007
Last updated
07/08/2007
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