Provider Demographics
NPI:1184005308
Name:HEALTHFIT MEDICAL PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:HEALTHFIT MEDICAL PROFESSIONALS, LLC
Other - Org Name:HEALTHFIT FAMILY MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLOW
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-886-4440
Mailing Address - Street 1:2356 MEADOWS BLVD
Mailing Address - Street 2:SUITE 140B
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8405
Mailing Address - Country:US
Mailing Address - Phone:303-218-7774
Mailing Address - Fax:303-660-5065
Practice Address - Street 1:2356 MEADOWS BLVD
Practice Address - Street 2:SUITE 140B
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8405
Practice Address - Country:US
Practice Address - Phone:303-218-7774
Practice Address - Fax:303-660-5065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODW0266OtherMEDICARE RR
CO76609774Medicaid
CODW0266OtherMEDICARE RR