MEDICARE: DR. RICARDO EMILIO 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	207R00000X	Internal Medicine Physician	9783	PR

General Provider Information

NPI Number	:	1558316794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICARDO EMILIO JIMENEZ M.D.

Provider Business Mailing Address
First Line	:	138 RAFAEL COCA NAVAS, QUINTAS LAS MUESAS
Second Line	:
City	:	CAYEY
State	:	PR
Zip	:	00736-0000
Country	:	US
Telephone Number	:	787-263-8669
Fax Number	:	787-263-4883

Provider Business Practice Location Address
First Line	:	60 AVE. BETANCE
Second Line	:
City	:	CAYEY
State	:	PR
Zip	:	00736-0000
Country	:	US
Telephone Number	:	787-738-2671
Fax Number	:	787-263-3110

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	06/07/2026

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