Provider Demographics
NPI:1740075050
Name:MAROTO, MAYA EDMONDS
Entity type:Individual
Prefix:DR
First Name:MAYA
Middle Name:EDMONDS
Last Name:MAROTO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14103 ALDORA CIR
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-2027
Mailing Address - Country:US
Mailing Address - Phone:410-570-5802
Mailing Address - Fax:
Practice Address - Street 1:14103 ALDORA CIR
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-2027
Practice Address - Country:US
Practice Address - Phone:410-570-5802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2780133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered