Provider Demographics
NPI:1417238569
Name:MARTINEZ ROURA, MARIA E (RD)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:E
Last Name:MARTINEZ ROURA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-0792
Mailing Address - Country:US
Mailing Address - Phone:787-505-5377
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL METROPOLITANO DR. TITO MATTEI
Practice Address - Street 2:STREET 128 KM. 1.0
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-856-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR906133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered