Provider Demographics
NPI:1821876491
Name:CARAVITA HEALTH LLC
Entity type:Organization
Organization Name:CARAVITA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:ANGLADA CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-761-1362
Mailing Address - Street 1:109 E 17TH ST STE 6178
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4543
Mailing Address - Country:US
Mailing Address - Phone:720-761-1362
Mailing Address - Fax:303-484-0429
Practice Address - Street 1:3065 CENTER GREEN DR STE 216
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2251
Practice Address - Country:US
Practice Address - Phone:720-910-1410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty