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1508239872 NPI number — ROBERTO ENRIQUE GIMENEZ APRN, DNP

NPI Number: 1508239872
Health Care Provider/Practitioner: ROBERTO ENRIQUE GIMENEZ APRN, DNP

Information about “1508239872” NPI (ROBERTO ENRIQUE GIMENEZ APRN, DNP) exists in 1508239872 in HTML format HTML  |  1508239872 in plain Text format TXT  |  1508239872 in PDF (Portable Document Format) PDF  |  1508239872 in an XML format XML  formats.

NPI Number : 1508239872 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508239872",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GIMENEZ",
    "FirstName": "ROBERTO",
    "MiddleName": "ENRIQUE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "APRN, DNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 198054",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ATLANTA",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30384-8054",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "786-662-7980",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "800 SW 108TH AVE STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MIAMI",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33174-2555",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-595-0000",
    "PracticeLocationAddressFaxNumber": "786-591-6173",
    "EnumerationDate": "11/08/2015",
    "LastUpdateDate": "09/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LP0808X",
        "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
        "LicenseNumber": "APRN9198046",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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