Provider Demographics
NPI:1679078083
Name:MEDINA AGRAMONTE, GEORGINA MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGINA
Middle Name:MARIA
Last Name:MEDINA AGRAMONTE
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:GEORGINA
Other - Middle Name:
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11300 ROCKVILLE PIKE STE 1202
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3040
Mailing Address - Country:US
Mailing Address - Phone:301-896-0890
Mailing Address - Fax:
Practice Address - Street 1:4301 CONNECTICUT AVE NW STE 125
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2332
Practice Address - Country:US
Practice Address - Phone:301-896-0890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0098211207W00000X
DCMD210012408207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology