Organization
LIVE WELL VENTURES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENISE HERNANDEZ MD (PRESIDENT)
(303) 902-2680
Entity
Organization
Contact information
Practice address
3760 VANCE ST # 201, WHEAT RIDGE, CO 80033-6298
(303) 902-2680
Mailing address
3760 VANCE ST # 201, WHEAT RIDGE, CO 80033-6298
(303) 902-2680
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
DR-43822
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73081744
—
CO
01
—
C804783
MEDICARE PTAN
CO
Enumeration date
02/06/2008
Last updated
08/19/2026
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