Provider Demographics
NPI:1770698995
Name:ZORRILLA, RUBEN EDUARDO (MD)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:EDUARDO
Last Name:ZORRILLA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 173362
Mailing Address - Street 2:CB 20
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-3362
Mailing Address - Country:US
Mailing Address - Phone:303-615-9999
Mailing Address - Fax:720-778-5850
Practice Address - Street 1:955 LAWRENCE WAY
Practice Address - Street 2:# 150
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204
Practice Address - Country:US
Practice Address - Phone:303-615-9999
Practice Address - Fax:720-778-5850
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0045060207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28200055Medicaid
COCO307573Medicare PIN