Healthcare Provider Details

I. General information

NPI: 1174650592
Provider Name (Legal Business Name): SYLVIA A VIGIL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 03/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 E BUCHTEL BLVD
DENVER CO
80208-0001
US

IV. Provider business mailing address

10350 E DAKOTA AVE
DENVER CO
80247-1314
US

V. Phone/Fax

Practice location:
  • Phone: 303-871-7730
  • Fax: 303-871-4242
Mailing address:
  • Phone: 303-338-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1280
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: