MEDICARE: WILLIAM FERNANDO 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	208D00000X	General Practice Physician	18740	PR
2	208D00000X	General Practice Physician	ACN798	FL

General Provider Information

NPI Number	:	1659781912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM FERNANDO JIMENEZ M.D.

Provider Business Mailing Address
First Line	:	105 S DIXIE DR
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-2844
Country	:	US
Telephone Number	:	863-421-1190
Fax Number	:	833-450-5402

Provider Business Practice Location Address
First Line	:	105 S DIXIE DR
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-2844
Country	:	US
Telephone Number	:	863-421-1190
Fax Number	:

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

Provider Enumeration Date	:	05/07/2014
Last Update Date	:	11/11/2025

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