Healthcare Provider Details

I. General information

NPI: 1023929460
Provider Name (Legal Business Name): JOANNA JIMENEZ PAVON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 BURNET AVE
CINCINNATI OH
45229-3091
US

IV. Provider business mailing address

PO BOX 636256
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-6663
  • Fax: 513-585-7778
Mailing address:
  • Phone: 513-585-6200
  • Fax: 513-245-3672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number80.000094
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: