Fons Vitae Intl, Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

D0078086 Issued in MD

Legal business name

FONS VITAE INTL, INC

Practice address

6144 Oxon Hill Rd
Oxon Hill, MD 20745-3107

Phone

(202) 215-0245

NPI assigned

Feb 24, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Grace Ortiz

Title

Credentialing Adm

Phone

(301) 519-9200

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1386004083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N ST NW APT 4A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200055161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 OXON HILL RD",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453107",
            "telephone_number": "202-215-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FONS VITAE INTL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "CREDENTIALING ADM",
        "authorized_official_telephone_number": "301-519-9200"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0078086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Oxon Hill, MD
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• Anesthesiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.