Individual
DR. MAURICIO REBOLLEDO MEDRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 S POTOMAC ST, AURORA, CO 80012-5411
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2013-0973
NM
207RI0200X
Infectious Disease Physician
BP10043748
TX
208M00000X
Hospitalist Physician
Primary
DR.0065753
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029245
KAISER COMMERCIAL NUMBER
CO
Enumeration date
05/01/2012
Last updated
08/21/2021
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