MEDICARE: YAUMARY JIMENEZ

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1891240826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAUMARY JIMENEZ

Provider Business Mailing Address
First Line	:	8420 SW 133RD AVENUE RD APT 124
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-4563
Country	:	US
Telephone Number	:	786-803-5214
Fax Number	:

Provider Business Practice Location Address
First Line	:	8420 SW 133RD AVENUE RD APT 124
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-4563
Country	:	US
Telephone Number	:	786-803-5214
Fax Number	:

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

Provider Enumeration Date	:	08/19/2016
Last Update Date	:	08/19/2016

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Directions to “ YAUMARY JIMENEZ ” Practice Location

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