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General NPI Number Information
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NPI Number | 1730700121
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Entity Type | Individual
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Provider Name | ROSA MARIA MARTINEZ DELOERA RD/LD
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Gender | Female
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Dates
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Enumeration Date | 04/27/2020
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 6800 NW 39TH EXPY
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City | BETHANY
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State | OK
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Zip | 73008-2513
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Country | US
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Telephone | 405-789-6711
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Fax | 405-438-3834
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Provider Business Mailing Address
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Address Line | 500 SW 44TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109
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Country | US
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Telephone | 405-632-6688
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Fax | 405-232-0716
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2470
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License Number State | OK
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