Provider Demographics
NPI:1912003435
Name:CIOTTI, SUZANNE RENEE LAFEX (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:RENEE LAFEX
Last Name:CIOTTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SUZANNE
Other - Middle Name:RENEE
Other - Last Name:LAFEX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 844088
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4088
Mailing Address - Country:US
Mailing Address - Phone:505-609-2258
Mailing Address - Fax:505-609-2259
Practice Address - Street 1:1970 E 3RD AVE STE 1
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5049
Practice Address - Country:US
Practice Address - Phone:970-444-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35606207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01356062Medicaid
CO0537968Medicare ID - Type Unspecified
CO01356062Medicaid