Provider Demographics
NPI:1437959251
Name:COLINDRES-BAUTISTA, KARINA
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:COLINDRES-BAUTISTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N FREDERICK AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2489
Mailing Address - Country:US
Mailing Address - Phone:202-510-8463
Mailing Address - Fax:
Practice Address - Street 1:101 N FREDERICK AVE APT 202
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2489
Practice Address - Country:US
Practice Address - Phone:202-510-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDW25201559174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist