Healthcare Provider Details

I. General information

NPI: 1891632147
Provider Name (Legal Business Name): ANGELO ENRIQUE MONTIEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 S POTOMAC ST STE 11
AURORA CO
80012-4527
US

IV. Provider business mailing address

12100 W 44TH AVE APT 216
WHEAT RIDGE CO
80033-2452
US

V. Phone/Fax

Practice location:
  • Phone: 720-845-6675
  • Fax:
Mailing address:
  • Phone: 720-232-9734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: