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General NPI Number Information
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NPI Number | 1508023110
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Entity Type | Individual
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Provider Name | MELISSA ANNE JIMENEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE ML 3008
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-9562
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE ML 3008
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-9562
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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 | 35.099163
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 204630
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License Number State | LA
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