Healthcare Provider Details

I. General information

NPI: 1982165015
Provider Name (Legal Business Name): LUCIA NOTARDONATO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9403 CROWN CREST BLVD STE 115
PARKER CO
80138-8882
US

IV. Provider business mailing address

9403 CROWN CREST BLVD STE 115
PARKER CO
80138-8882
US

V. Phone/Fax

Practice location:
  • Phone: 303-269-4420
  • Fax: 303-269-4439
Mailing address:
  • Phone: 303-269-4420
  • Fax: 303-269-4439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0075295
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.073569
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: