Provider Demographics
NPI:1285416529
Name:DELGADO MARTINEZ, RITA LORENNA
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:LORENNA
Last Name:DELGADO MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 SW 87TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2427
Mailing Address - Country:US
Mailing Address - Phone:786-372-2843
Mailing Address - Fax:786-409-2526
Practice Address - Street 1:14221 SW 120TH ST STE 229
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4225
Practice Address - Country:US
Practice Address - Phone:786-445-2848
Practice Address - Fax:786-409-2526
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11775235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist