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General NPI Number Information
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NPI Number | 1194929224
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Entity Type | Individual
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Provider Name | MARIA C JIMENEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | HOPITAL PEDIATRICO UNIVERSITARIO CENTRO MEDICO DE PUERTO RICO
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City | SAN JUAN
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State | PR
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Zip | 00919-1079
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Country | US
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Telephone | 787-777-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 405 JUAN B RODRIGUEZ APT 7042
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City | SAN JUAN
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State | PR
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Zip | 00918-2520
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Country | US
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Telephone | 787-501-4451
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 17547
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 17547
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License Number State | PR
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