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General NPI Number Information
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NPI Number | 1609841667
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Entity Type | Individual
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Provider Name | CARLOS E JIMENEZ MD
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | ASHFORD PRESBY HOSPITAL NUCLEAR MEDICINE LABORATORY 1ST FLOOR , ASHFORD AVE
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone | 787-724-3500
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Fax | 787-725-0485
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Provider Business Mailing Address
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Address Line | 35 JUAN BORBON ST PMB 130
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City | GUAYNABO
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State | PR
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Zip | 00969-5375
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Country | US
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Telephone | 787-724-3500
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Fax | 787-725-0485
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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 | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number | 11046
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 11046
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License Number State | PR
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