Healthcare Provider Details

I. General information

NPI: 1669059176
Provider Name (Legal Business Name): ALEJANDRO JOSE JIMENEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 BEVERLY RD STE 300
MC LEAN VA
22101-3734
US

IV. Provider business mailing address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

V. Phone/Fax

Practice location:
  • Phone: 202-295-0540
  • Fax:
Mailing address:
  • Phone: 202-444-1665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD600005626
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: