MEDICARE: ALEXANDER ALBEAR GONGORA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	NVMT12964	NV

General Provider Information

NPI Number	:	1124978903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER ALBEAR GONGORA

Provider Business Mailing Address
First Line	:	8329 DAWN BREEZE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4614
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8329 DAWN BREEZE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4614
Country	:	US
Telephone Number	:	725-227-0381
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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Directions to “ ALEXANDER ALBEAR GONGORA ” Practice Location

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