Provider Demographics
NPI:1427319045
Name:TUBUO, VIOLET
Entity type:Individual
Prefix:
First Name:VIOLET
Middle Name:
Last Name:TUBUO
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 1:5501 DORIS CT
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1649
Mailing Address - Country:US
Mailing Address - Phone:240-646-4715
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AV
Practice Address - Street 2:117 GLOBAL HEALH CARE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002
Practice Address - Country:US
Practice Address - Phone:202-480-0813
Practice Address - Fax:202-503-2363
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DC1048713163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide