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: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9025 PINES BLVD
PEMBROKE PINES FL
33024-6440
US

IV. Provider business mailing address

9025 PINES BLVD
PEMBROKE PINES FL
33024-6440
US

V. Phone/Fax

Practice location:
  • Phone: 954-417-0003
  • Fax: 954-417-0004
Mailing address:
  • Phone: 954-417-0003
  • Fax: 954-417-0004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9229293
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN9229293
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberRN9229293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: