Healthcare Provider Details

I. General information

NPI: 1427340389
Provider Name (Legal Business Name): BRENDA LATOWSKY M.D. P.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8841 E BELL RD STE 201
SCOTTSDALE AZ
85260-1984
US

IV. Provider business mailing address

8841 E BELL RD STE 201
SCOTTSDALE AZ
85260-1984
US

V. Phone/Fax

Practice location:
  • Phone: 602-971-0950
  • Fax: 602-992-4971
Mailing address:
  • Phone: 602-971-0950
  • Fax: 602-992-4971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number41903
License Number StateAZ

VIII. Authorized Official

Name: MS. JENNA SANFORD
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 480-398-1550