Patrick Benavidez, MASSAGE THERAPIST
Individual provider Active NPI Massage Therapist · Los Ranchos, NM
NPI 1245714583 · NPPES record last updated Sep 22, 2018
Key facts
- NPI
- 1245714583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 8928 (NM)
- Practice address
- 6855 4TH St NW Ste B2
Los Ranchos, NM 87107-6100 - Phone
- (505) 508-2752
- NPI assigned
- Sep 22, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8928 | NM | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GC Ventures and Co. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 8928 | NM | Yes |
Addresses
Primary practice location
6855 4TH St NW Ste B2
Los Ranchos, NM 87107-6100
Mailing address
1405 Loma Hermosa Dr NW
Albuquerque, NM 87105-1131
Phone (505) 836-5199
Other providers in Los Ranchos, NM
- Taylor Archuleta
- Armada Home Healthcare of Socorro LLC
- Yelena Baras
- Dianne Renee Barnes
- Gerard Thomas Bartlett
- Sylvia Cruz Bencomo
- Boldly Resilient LLC
- Frank Brady
- Fiona Breslin
- Charles Rand Briggs
All providers in Los Ranchos, NM · Massage Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.