| Doctor Name: | LARISA Y RAVDEL |
| NPI Number: | 1407007461 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 40458 |
| Business Practice Address: | 1421 S Potomac St Ste 320 Aurora, CO - 800124512 |
| Business Phone Number: | 3037501920 |
| Business Fax Number: | 3037500483 |
| Mailing Address: | 1421 S Potomac St Ste 320, AURORA |
| State: | CO |
| Postal Code: | 800124512 |
| Phone Number: | 3037501920 |
| Fax Number: | 3037500483 |
| NPI Enumeration Date: | 10/08/2008 |
| NPI Last Update Date: | 06/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 40458 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |