Healthcare Provider Details

I. General information

NPI: 1861659971
Provider Name (Legal Business Name): ALINA JIMENEZ BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13768 SW 8TH ST
MIAMI FL
33184-3030
US

IV. Provider business mailing address

11031 NE 6TH AVE
MIAMI FL
33161-7182
US

V. Phone/Fax

Practice location:
  • Phone: 855-226-6633
  • Fax: 786-293-9594
Mailing address:
  • Phone: 305-398-6100
  • Fax: 305-757-4465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9413278
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: