Provider Demographics
NPI:1376027334
Name:GENTLE TOUCH BREAST DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:GENTLE TOUCH BREAST DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVELLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-470-2503
Mailing Address - Street 1:1505 N UNIVERSITY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8975
Mailing Address - Country:US
Mailing Address - Phone:754-702-7267
Mailing Address - Fax:
Practice Address - Street 1:1505 N UNIVERSITY DR STE 100
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8975
Practice Address - Country:US
Practice Address - Phone:754-702-7267
Practice Address - Fax:866-663-1071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty