Provider Demographics
NPI:1164012183
Name:LAVOIGNET, OCTAVIO RUBEN
Entity Type:Individual
Prefix:
First Name:OCTAVIO
Middle Name:RUBEN
Last Name:LAVOIGNET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 N LINCOLN ST APT 12D
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2768
Mailing Address - Country:US
Mailing Address - Phone:720-233-5485
Mailing Address - Fax:
Practice Address - Street 1:925 N LINCOLN ST APT 12D
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2768
Practice Address - Country:US
Practice Address - Phone:720-233-5485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter