Provider Demographics
NPI:1538104641
Name:VILLAFLOR, EVANGELINE SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:EVANGELINE
Middle Name:SUE
Last Name:VILLAFLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:455 SHERMAN ST
Mailing Address - Street 2:STE 510
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4400
Mailing Address - Country:US
Mailing Address - Phone:303-377-6825
Mailing Address - Fax:303-780-0787
Practice Address - Street 1:455 SHERMAN ST
Practice Address - Street 2:STE 510
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4400
Practice Address - Country:US
Practice Address - Phone:303-377-6825
Practice Address - Fax:303-780-0787
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO34311207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1343110Medicaid
CO029444OtherKAISER COMMERCIAL NUMBER