Healthcare Provider Details

I. General information

NPI: 1437212404
Provider Name (Legal Business Name): GIANCARLO BAROLAT-ROMANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GIANCARLO BAROLAT-ROMANA MD

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 02/09/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 E 19TH AVE #434
DENVER CO
80218-1251
US

IV. Provider business mailing address

4900 S MONACO ST SUITE 210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-865-7800
  • Fax: 303-865-7804
Mailing address:
  • Phone: 303-865-7800
  • Fax: 303-865-7804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD43166
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number43166
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: