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

Divine Health Medical and Spa LLC

Organization Primary Care Clinic/Center · NPI 1790428555

Divine Health Medical and Spa LLC is a Primary Care Clinic/Center in Rockville, Maryland. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
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

11119 Rockville Pike Ste 320
Rockville, MD 20852-3143
Phone: (240) 669-6598
Fax: (240) 669-6079
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1790428555
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sally Young — Educator · (240) 437-9997
NPI enumeratedApril 19, 2022
Last updated in NPPESJuly 14, 2022
Certification dateJuly 14, 2022
Mailing address12406 Buckley Dr, Silver Spring, MD 20904-2017

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