Provider Demographics
NPI:1174752950
Name:KIM, MARIA FATIMA MAPA (DPT)
Entity type:Individual
Prefix:
First Name:MARIA FATIMA
Middle Name:MAPA
Last Name:KIM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARIA FATIMA
Other - Middle Name:LIMCANGCO
Other - Last Name:MAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:202 PARK AVE
Mailing Address - Street 2:APT 302
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2943
Mailing Address - Country:US
Mailing Address - Phone:301-980-3898
Mailing Address - Fax:
Practice Address - Street 1:9420 KEY WEST AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3334
Practice Address - Country:US
Practice Address - Phone:301-972-4752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist