Provider Demographics
NPI:1619974888
Name:BREWINGTON, FLORA H (MD)
Entity Type:Individual
Prefix:DR
First Name:FLORA
Middle Name:H
Last Name:BREWINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 PECOS ST STE 500
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3995
Mailing Address - Country:US
Mailing Address - Phone:303-457-4497
Mailing Address - Fax:303-254-4369
Practice Address - Street 1:12201 PECOS ST STE 500
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-3995
Practice Address - Country:US
Practice Address - Phone:303-457-4497
Practice Address - Fax:303-254-4369
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-03
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47323388Medicaid
CO47323388Medicaid
COCE3108Medicare PIN
CO801096Medicare PIN