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General NPI Number Information
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NPI Number | 1962523555
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Entity Type | Individual
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Provider Name | ELISA GUARDIOLA MELENDEZ MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 1181 E. 120TH AVE, UNIT A
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City | THORNTON
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State | CO
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Zip | 80233
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Country | US
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Telephone | 303-673-1500
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Fax | 303-689-6664
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Provider Business Mailing Address
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Address Line | 5075 LINCOLN ST
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City | DENVER
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State | CO
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Zip | 80216-2015
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Country | US
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Telephone | 303-458-5302
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Fax | 303-433-7452
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 46156
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License Number State | CO
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