Healthcare Provider Details

I. General information

NPI: 1447487384
Provider Name (Legal Business Name): MERCEDES JIMENEZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 E 4TH AVE
HIALEAH FL
33013-2703
US

IV. Provider business mailing address

5605 NW 82ND AVE
DORAL FL
33166-4000
US

V. Phone/Fax

Practice location:
  • Phone: 305-685-5688
  • Fax: 305-693-0768
Mailing address:
  • Phone: 305-685-5688
  • Fax: 786-618-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9229293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: