MEDICARE: DR. MAYKEL JIMENEZ D.C.

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	111N00000X	Chiropractor	CH10366	FL

General Provider Information

NPI Number	:	1568741304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAYKEL JIMENEZ D.C.

Provider Business Mailing Address
First Line	:	3540 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3031
Country	:	US
Telephone Number	:	305-742-8471
Fax Number	:

Provider Business Practice Location Address
First Line	:	2464 CORAL WAY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-3419
Country	:	US
Telephone Number	:	786-294-0710
Fax Number	:

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

Provider Enumeration Date	:	08/10/2011
Last Update Date	:	11/06/2013

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