Healthcare Provider Details

I. General information

NPI: 1164126959
Provider Name (Legal Business Name): ANDREA M JIMENEZ NEGRON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

METRO OFFICE PARK
GUAYNABO PR
00968-1704
US

IV. Provider business mailing address

1717 AVE PONCE DE LEON PH 6
SAN JUAN PR
00909-1972
US

V. Phone/Fax

Practice location:
  • Phone: 787-365-7161
  • Fax:
Mailing address:
  • Phone: 787-365-7161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number904
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: