Healthcare Provider Details

I. General information

NPI: 1053256891
Provider Name (Legal Business Name): CHRISTOPHER WILLIAM JIMENEZ GONZALEZ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 G, 1 AVENIDA NOEL ESTRADA
ISABELA PR
00662
US

IV. Provider business mailing address

870 CALLE CONCEPCION VERA
MOCA PR
00676-5061
US

V. Phone/Fax

Practice location:
  • Phone: 787-872-1930
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number008352
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: