Organization
COLORADO MEDICAL GROUP, PLLC
Active
Parent organization
COLORADO MEDICAL GROUP, PLLC
Other names
United Vein Centers of Centennial, CO
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO MEDICAL GROUP, PLLC
Authorized official
GRACE SIMMONS (CREDENTIALING DIRECTOR)
(813) 867-0606
Entity
Organization
Contact information
Practice address
3535 S LAFAYETTE ST STE 100, ENGLEWOOD, CO 80113-3954
(800) 991-6117
(888) 812-8191
Mailing address
3810 NORTHDALE BLVD STE 150, TAMPA, FL 33624-1871
(813) 961-1331
(888) 850-8316
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
07/24/2023
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