Healthcare Provider Details

I. General information

NPI: 1386282085
Provider Name (Legal Business Name): LATOYA KASMIR GILMORE CNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 12/13/2019
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10233 S PARKER RD STE 105
PARKER CO
80134-9314
US

IV. Provider business mailing address

4600 S ULSTER ST STE 1225
DENVER CO
80237-2696
US

V. Phone/Fax

Practice location:
  • Phone: 720-287-3093
  • Fax: 720-287-3195
Mailing address:
  • Phone: 720-287-9093
  • Fax: 720-287-3195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number3827
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: