MEDICARE: CRISTINA GONZALES

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	MT0028169	CO

General Provider Information

NPI Number	:	1730016031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA GONZALES

Provider Business Mailing Address
First Line	:	925 S MEADE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-3340
Country	:	US
Telephone Number	:	720-248-8338
Fax Number	:

Provider Business Practice Location Address
First Line	:	2594 S LEWIS WAY UNIT E
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-2839
Country	:	US
Telephone Number	:	720-248-8338
Fax Number	:

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

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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