Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Diane Tackie Granillo, LLC

Organization Medical Physician Assistant · NPI 1972393171

Diane Tackie Granillo, LLC is a Medical Physician Assistant in Rockville, Maryland. Works from 3 locations. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1395 Piccard Dr Ste 200
Rockville, MD 20850-4348
Phone: (202) 951-7942
Fax: (202) 971-1991
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1100 H St Nw Ste 1100, Washington, DC 20005-5967 — (202) 951-7942
  • 40 York Rd Ste 110, Towson, MD 21204-5243 — (202) 951-7942

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1972393171
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Tackie Granillo — Owner · (202) 951-7942
NPI enumeratedMay 9, 2025
Last updated in NPPESMarch 19, 2026
Certification dateMarch 19, 2026
Mailing address1395 Piccard Dr Ste 200, Rockville, MD 20850-4348

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