Healthcare Provider Details

I. General information

NPI: 1760108187
Provider Name (Legal Business Name): ANA MARIA MEJIA JIMENEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 MARY ST STE 300
MIAMI FL
33133-5293
US

IV. Provider business mailing address

100 KINGS POINT DR APT 1510
SUNNY ISLES BEACH FL
33160-4730
US

V. Phone/Fax

Practice location:
  • Phone: 305-908-1115
  • Fax: 305-675-3135
Mailing address:
  • Phone: 407-790-5983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11016485
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11016485
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: