MEDICARE: DR. FRANCIS ESCOLIN JIMENEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9268	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	880504273	OTHER	NV	TAX IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	NV9268	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1346329851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS ESCOLIN JIMENEZ M.D.

Provider Business Mailing Address
First Line	:	2810 W CHARLESTON BLVD
Second Line	:	STE 47
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1960
Country	:	US
Telephone Number	:	702-258-4469
Fax Number	:	702-259-0239

Provider Business Practice Location Address
First Line	:	3009 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1943
Country	:	US
Telephone Number	:	702-258-4469
Fax Number	:	702-259-0239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	05/11/2016

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