Provider Demographics
NPI:1184032070
Name:ZAVALETTA, VANESSA (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:ZAVALETTA
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:DR
Other - First Name:VAZ
Other - Middle Name:
Other - Last Name:ZAVALETTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD PHD
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA857792085R0204X
CODR.00666472085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology