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General NPI Number Information
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NPI Number | 1154902807
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Entity Type | Organization
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Legal Business Name | ALICIA JIMENEZ APRN LLC
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 1000 W PEMBROKE RD STE 322
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-2181
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Country | US
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Telephone | 954-932-0299
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Fax | 954-932-0298
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Provider Business Mailing Address
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Address Line | 1000 W PEMBROKE RD STE 322
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-2181
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Country | US
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Telephone | 954-932-0299
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Fax | 954-932-0298
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ALICIA JIMENEZ
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Credential | APRN
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Telephone | 954-932-0299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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