Provider Demographics
NPI:1528554664
Name:ROMA, MARIA ISABELLA ORTEGA (OD)
Entity Type:Individual
Prefix:
First Name:MARIA ISABELLA
Middle Name:ORTEGA
Last Name:ROMA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18002 GOLDEN SPRING CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1773
Mailing Address - Country:US
Mailing Address - Phone:202-384-5901
Mailing Address - Fax:
Practice Address - Street 1:8359 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2492
Practice Address - Country:US
Practice Address - Phone:703-442-9295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist