Provider Demographics
NPI:1720190812
Name:GIMBEL, DENISE K (D C)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:K
Last Name:GIMBEL
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 W PALMETTO PARK RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-3314
Mailing Address - Country:US
Mailing Address - Phone:561-338-9200
Mailing Address - Fax:561-338-3651
Practice Address - Street 1:1383 W PALMETTO PARK RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-3314
Practice Address - Country:US
Practice Address - Phone:561-338-9200
Practice Address - Fax:561-338-3651
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53862OtherBLUE CROSS BLUE SHIELD