Healthcare Provider Details

I. General information

NPI: 1033259353
Provider Name (Legal Business Name): GENTLE CARE PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2904 HILLRISE DR
LAS CRUCES NM
88011-4702
US

IV. Provider business mailing address

PO BOX 1560
LAS CRUCES NM
88004-1560
US

V. Phone/Fax

Practice location:
  • Phone: 505-532-5377
  • Fax: 505-522-3772
Mailing address:
  • Phone: 505-647-8366
  • Fax: 505-647-8381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARINA ARMENDARIZ
Title or Position: OWNER
Credential: M.D.
Phone: 505-532-5377