Healthcare Provider Details

I. General information

NPI: 1912003435
Provider Name (Legal Business Name): SUZANNE RENEE LAFEX CIOTTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE RENEE LAFEX MD

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1970 E 3RD AVE STE 1
DURANGO CO
81301-5049
US

IV. Provider business mailing address

PO BOX 844088
DALLAS TX
75284-4088
US

V. Phone/Fax

Practice location:
  • Phone: 970-444-0260
  • Fax:
Mailing address:
  • Phone: 505-609-2258
  • Fax: 505-609-2259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35606
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: