Healthcare Provider Details

I. General information

NPI: 1750962296
Provider Name (Legal Business Name): DEYZE BADARANE MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12631 E 17TH AVE FL 2
AURORA CO
80045-2527
US

IV. Provider business mailing address

12631 E 17TH AVE FL 2
AURORA CO
80045-2527
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-3483
  • Fax: 303-724-1105
Mailing address:
  • Phone: 303-724-3483
  • Fax: 303-724-1105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDR.0072325
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number0008664
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: