Healthcare Provider Details

I. General information

NPI: 1619359452
Provider Name (Legal Business Name): JOSE HUMBERTO JIMENEZ - ALMONTE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2015
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 N CHARLES RICHARD BEALL BLVD
DEBARY FL
32713-2203
US

IV. Provider business mailing address

2954 MALLORY CIR STE 101
CELEBRATION FL
34747-1822
US

V. Phone/Fax

Practice location:
  • Phone: 321-939-0222
  • Fax:
Mailing address:
  • Phone: 321-939-0222
  • Fax: 321-939-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME153425
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberME153425
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: