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General NPI Number Information
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NPI Number | 1326665746
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Entity Type | Individual
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Provider Name | CORAL KAOMA JIMENEZ ROVIRA
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Gender | Female
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | PLAZA REAL SHOPPING CENTER SUITE 202
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-833-3196
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Fax |
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Provider Business Mailing Address
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Address Line | 1 AVE ALBOLOTE PLAZA REAL SHOPPING 202
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 939-373-6791
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 22627
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME161449
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License Number State | FL
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