MEDICARE: REBECCA DENICE FLORES ONTIVEROS

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	023376	TX

General Provider Information

NPI Number	:	1265200919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA DENICE FLORES ONTIVEROS

Provider Business Mailing Address
First Line	:	1205 LAFAYETTE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-1219
Country	:	US
Telephone Number	:	915-253-8041
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 LAFAYETTE DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-1219
Country	:	US
Telephone Number	:	915-253-8041
Fax Number	:

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

Provider Enumeration Date	:	12/12/2023
Last Update Date	:	10/01/2024

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Directions to “ REBECCA DENICE FLORES ONTIVEROS ” Practice Location

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