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NPI Code Detail

MEDICARE: NANCY M JIMENEZ MA MHC

MEDICARE: NANCY M JIMENEZ MA MHC
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
1101YM0800XMental Health Counselor
2106H00000XMarriage & Family Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558541920
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY M JIMENEZ MA MHC
Provider Business Mailing Address
First Line : 3707 DALEFORD RD
Second Line :
City : ORLANDO
State : FL
Zip : 32808-2305
Country : US
Telephone Number : 407-925-9744
Fax Number :
Provider Business Practice Location Address
First Line : 3707 DALEFORD RD
Second Line :
City : ORLANDO
State : FL
Zip : 32808-2305
Country : US
Telephone Number : 407-925-9744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2007
Last Update Date : 11/13/2007

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