Provider Demographics
NPI:1376769653
Name:CIARDELLA, JASMELIZ LUGTU (MD)
Entity Type:Individual
Prefix:
First Name:JASMELIZ
Middle Name:LUGTU
Last Name:CIARDELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JASMELIZ
Other - Middle Name:MANZON
Other - Last Name:LUGTU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1401 WEWATTA ST
Mailing Address - Street 2:UNIT #1204
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202
Mailing Address - Country:US
Mailing Address - Phone:303-825-5858
Mailing Address - Fax:303-825-5858
Practice Address - Street 1:777 BANNOCK STREET
Practice Address - Street 2:DENVER HEALTH MEDICAL CENTER DEPT OF OPHTHAMOLOGY
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204
Practice Address - Country:US
Practice Address - Phone:303-436-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41965207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology