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General NPI Number Information
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NPI Number | 1326900242
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Entity Type | Organization
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Legal Business Name | JIMENEZ DIAZ SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1111 COMMONWEALTH AVE APT 8TT
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City | BRONX
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State | NY
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Zip | 10472-1038
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Country | US
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Telephone | 347-364-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 COMMONWEALTH AVE APT 8TT
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City | BRONX
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State | NY
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Zip | 10472-1038
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Country | US
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Telephone | 347-364-0990
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARIA DIAZ DIAZ
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Credential |
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Telephone | 347-363-0990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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