Healthcare Provider Details

I. General information

NPI: 1952669640
Provider Name (Legal Business Name): FERNANDO JOSE FUENTES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: FERNANDO JOSE FUENTES ALFARO MD

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 JACKSON ST
DENVER CO
80206-2762
US

IV. Provider business mailing address

1400 JACKSON ST
DENVER CO
80206-2762
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-4461
  • Fax: 303-398-1211
Mailing address:
  • Phone: 303-388-4461
  • Fax: 303-398-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberDR.0072998
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberDR.0072998
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: