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General NPI Number Information
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NPI Number | 1124691746
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Entity Type | Individual
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Provider Name | RHONDA KAYE BENAVIDES DN, MBA, PTA
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 4015 CARLISLE BLVD NE STE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-4529
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Country | US
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Telephone | 505-591-6277
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Fax | 505-508-0932
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Provider Business Mailing Address
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Address Line | 4015 CARLISLE BLVD NE STE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-4529
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Country | US
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Telephone | 505-591-6277
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Fax | 505-509-0932
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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 | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA-0963
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 172P00000X
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Taxonomy Name | Naprapath
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License Number | DN2023-0002
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License Number State | NM
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