Healthcare Provider Details

I. General information

NPI: 1609058890
Provider Name (Legal Business Name): ALEJANDRO JIMENEZ RESTREPO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 311
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

P O BOX 70280 LOCKBOX 10346
PHILADELPHIA PA
19176-0280
US

V. Phone/Fax

Practice location:
  • Phone: 561-434-0353
  • Fax: 561-357-0869
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME163451
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: