Individual
DANIEL RAFAEL ONTIVEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
12850 MIDDLEBROOK RD STE 307, GERMANTOWN, MD 20874-5244
(301) 972-4752
(301) 972-4836
Mailing address
12850 MIDDLEBROOK RD STE 307, GERMANTOWN, MD 20874-5244
(301) 972-4752
(301) 972-4836
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25689
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y0KX9
FLORIDA BLUE
FL
Enumeration date
12/11/2013
Last updated
11/25/2020
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