Provider Demographics
NPI:1124691746
Name:BENAVIDES, RHONDA KAYE (DN, MBA, PTA)
Entity type:Individual
Prefix:PROF
First Name:RHONDA
Middle Name:KAYE
Last Name:BENAVIDES
Suffix:
Gender:F
Credentials:DN, MBA, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 CARLISLE BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4529
Mailing Address - Country:US
Mailing Address - Phone:505-591-6277
Mailing Address - Fax:505-509-0932
Practice Address - Street 1:4015 CARLISLE BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4529
Practice Address - Country:US
Practice Address - Phone:505-591-6277
Practice Address - Fax:505-508-0932
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
NMPTA-0963225200000X
NMDN2023-0002172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172P00000XOther Service ProvidersNaprapath
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant