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General NPI Number Information
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NPI Number | 1669296232
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Entity Type | Individual
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Provider Name | ODALYS SANDOVAL JIMENEZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 10201 HAMMOCKS BLVD STE 122
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City | MIAMI
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State | FL
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Zip | 33196-3783
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Country | US
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Telephone | 786-701-8702
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Fax | 305-397-2669
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Provider Business Mailing Address
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Address Line | 13424 SW 62ND ST APT P112
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City | MIAMI
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State | FL
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Zip | 33183-1847
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Country | US
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Telephone | 786-319-2317
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11036199
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License Number State | FL
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