Provider Demographics
NPI:1740423961
Name:CARAVEO, YADIRA (MD)
Entity Type:Individual
Prefix:
First Name:YADIRA
Middle Name:
Last Name:CARAVEO
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 1:2691 E 121ST PL
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3450
Mailing Address - Country:US
Mailing Address - Phone:720-280-9405
Mailing Address - Fax:
Practice Address - Street 1:2691 E 121ST PL
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3450
Practice Address - Country:US
Practice Address - Phone:720-280-9405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0051503208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO086852833Medicaid