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General NPI Number Information
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NPI Number | 1144636846
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Entity Type | Individual
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Provider Name | JIMENA MARINO-NIETO M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 21C COND SANTA ANA
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-480-2791
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 NW 12TH AVE # C-301
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-6970
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Fax | 305-545-6501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME136422
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License Number State | FL
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