Provider Demographics
NPI:1639385057
Name:ONCENA, RACHELL RODA FLORES
Entity Type:Individual
Prefix:
First Name:RACHELL RODA
Middle Name:FLORES
Last Name:ONCENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 WAUGH CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1608
Mailing Address - Country:US
Mailing Address - Phone:443-292-7345
Mailing Address - Fax:443-292-7338
Practice Address - Street 1:1221 WAUGH CHAPEL RD
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1608
Practice Address - Country:US
Practice Address - Phone:443-292-7345
Practice Address - Fax:443-292-7338
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21335225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist