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NPI Code Detail

MEDICARE: DOCTOR BENEVOLO SEDAKA LMT, CPC

MEDICARE:   DOCTOR BENEVOLO SEDAKA  LMT, CPC
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
1225700000XMassage TherapistMT.0022455CO
2171400000XHealth & Wellness Coach

General Provider Information

NPI Number : 1306970884
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOCTOR BENEVOLO SEDAKA LMT, CPC
Provider Business Mailing Address
First Line : 4124 WOLFF ST
Second Line :
City : DENVER
State : CO
Zip : 80212-2228
Country : US
Telephone Number : 802-468-7253
Fax Number : 805-709-1282
Provider Business Practice Location Address
First Line : 4124 WOLFF ST
Second Line :
City : DENVER
State : CO
Zip : 80212-2228
Country : US
Telephone Number : 802-468-7253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 11/26/2025

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Directions to “ DOCTOR BENEVOLO SEDAKA LMT, CPC” Practice Location

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