Healthcare Provider Details

I. General information

NPI: 1891254827
Provider Name (Legal Business Name): DAMAYSI JIMENEZ ROJAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4218 E 4TH AVE
HIALEAH FL
33013-2306
US

IV. Provider business mailing address

4540 SW 104TH AVE
MIAMI FL
33165-5635
US

V. Phone/Fax

Practice location:
  • Phone: 305-571-6292
  • Fax:
Mailing address:
  • Phone: 305-263-0283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1175
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: