Healthcare Provider Details

I. General information

NPI: 1609207307
Provider Name (Legal Business Name): GILBERT MADRID HINOJOSA JR. CRTT, RPFT,SDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2013
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 E 20TH AVE
DENVER CO
80205-5422
US

IV. Provider business mailing address

1375 EAST 20TH AVE
DENVER CO
80205
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-3640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberRTL. 0000745
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: