Provider Demographics
NPI:1386282085
Name:GILMORE, LATOYA KASMIR (CNIM)
Entity type:Individual
Prefix:
First Name:LATOYA
Middle Name:KASMIR
Last Name:GILMORE
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4600 S ULSTER ST STE 1225
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2696
Mailing Address - Country:US
Mailing Address - Phone:720-287-9093
Mailing Address - Fax:720-287-3195
Practice Address - Street 1:10233 S PARKER RD STE 105
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9314
Practice Address - Country:US
Practice Address - Phone:720-287-3093
Practice Address - Fax:720-287-3195
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3827225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist