Provider Demographics
NPI:1891112009
Name:PEDROZA, MARITZA
Entity type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:PEDROZA
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 1:5121 PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1871
Mailing Address - Country:US
Mailing Address - Phone:615-838-0639
Mailing Address - Fax:
Practice Address - Street 1:5121 PEBBLE CREEK DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-1871
Practice Address - Country:US
Practice Address - Phone:615-838-0639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula