MEDICARE: GRICEL CHAVARRIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1730373911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRICEL CHAVARRIA

Provider Business Mailing Address
First Line	:	3429 S URAVAN WAY
Second Line	:	APT 305
City	:	AURORA
State	:	CO
Zip	:	80013-4499
Country	:	US
Telephone Number	:	720-224-2688
Fax Number	:

Provider Business Practice Location Address
First Line	:	3429 S URAVAN WAY
Second Line	:	APT 305
City	:	AURORA
State	:	CO
Zip	:	80013-4499
Country	:	US
Telephone Number	:	720-224-2688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	08/30/2007

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Directions to “ GRICEL CHAVARRIA ” Practice Location

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