Healthcare Provider Details

I. General information

NPI: 1770698995
Provider Name (Legal Business Name): RUBEN EDUARDO ZORRILLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/03/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 LAWRENCE WAY # 150
DENVER CO
80204
US

IV. Provider business mailing address

PO BOX 173362 CB 20
DENVER CO
80217-3362
US

V. Phone/Fax

Practice location:
  • Phone: 303-615-9999
  • Fax: 720-778-5850
Mailing address:
  • Phone: 303-615-9999
  • Fax: 720-778-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0045060
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: