Provider Demographics
NPI:1780889204
Name:GLEISNER, ANA LUIZA MANDELLI (MD)
Entity type:Individual
Prefix:DR
First Name:ANA LUIZA
Middle Name:MANDELLI
Last Name:GLEISNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANA
Other - Middle Name:
Other - Last Name:GLEISNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:12631 E 17TH AVE RM 6001
Mailing Address - Street 2:MAIL STOP C313
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2527
Mailing Address - Country:US
Mailing Address - Phone:303-724-8341
Mailing Address - Fax:
Practice Address - Street 1:12631 E 17TH AVE RM 6001
Practice Address - Street 2:MAIL STOP C313
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2527
Practice Address - Country:US
Practice Address - Phone:303-724-8341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR00554242086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology