Provider Demographics
NPI:1366562050
Name:CANETE, LUCILA ZAFRA (MD)
Entity type:Individual
Prefix:DR
First Name:LUCILA
Middle Name:ZAFRA
Last Name:CANETE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LUCILLE
Other - Middle Name:Z
Other - Last Name:CANETE-NELSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10310 NEWGATE CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5843
Mailing Address - Country:US
Mailing Address - Phone:410-461-2749
Mailing Address - Fax:301-443-9592
Practice Address - Street 1:5600 FISHERS LN
Practice Address - Street 2:5B-16
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20857-0001
Practice Address - Country:US
Practice Address - Phone:301-443-1238
Practice Address - Fax:301-443-9592
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020298171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider