Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Longevity Clinical Ltc Associates of Colorado PLLC

Organization Family Medicine Physician · NPI 1972269793

Longevity Clinical Ltc Associates of Colorado PLLC is a Family Medicine Physician in Lakewood, Colorado. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12136 W Bayaud Ave
Lakewood, CO 80228-2115
Phone: (303) 238-3838
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Family Medicine) Physician (primary) Taxonomy 207QG0300X
Family Medicine Physician Taxonomy 207Q00000X
Gerontology Nurse Practitioner Taxonomy 363LG0600X
Primary Care Nurse Practitioner Taxonomy 363LP2300X

Record details

NPI number1972269793
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Vincur — Clinical Support Talent Specialist · (561) 815-2427
NPI enumeratedNovember 16, 2021
Last updated in NPPESNovember 16, 2021
Certification dateNovember 16, 2021
Mailing address11770 Us Highway 1 Ste 102e, Palm Beach Gardens, FL 33408-3052

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