OrganizationActive
Longevity Clinical Ltc Associates of Colorado PLLC
NPI 1972269793 · Geriatric Medicine (Family Medicine) Physician · Lakewood, CO
Provider details
- NPI number
- 1972269793
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Diane Vincur, Clinical Support Talent Specialist(561) 815-2427
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Gerontology Nurse Practitioner363LG0600X
Physician Assistants & Advanced Practice Nursing Providers
- Primary Care Nurse Practitioner363LP2300X
Physician Assistants & Advanced Practice Nursing Providers
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Practice location
12136 W Bayaud Ave
Lakewood, CO 80228-2115
Phone: (303) 238-3838
Approximate (ZIP-level) locationGet directions
Mailing address
11770 US Highway 1 Ste 102e
Palm Beach Gardens, FL 33408-3052
Registry dates
- Enumerated
- 2021-11-16
- Last updated
- 2021-11-16
- Certified
- 2021-11-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.