Healthcare Provider Details

I. General information

NPI: 1144608035
Provider Name (Legal Business Name): DANIEL E URCUYO LLANES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E HAMPDEN AVE STE 100
ENGLEWOOD CO
80113-2517
US

IV. Provider business mailing address

180 E HAMPDEN AVE STE 100
ENGLEWOOD CO
80113-2517
US

V. Phone/Fax

Practice location:
  • Phone: 303-789-6018
  • Fax:
Mailing address:
  • Phone: 303-789-6018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.132158
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0059483
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: