=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801070990
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YEISABETH MARIE JIMENEZ ALMEYDA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/26/2007
-----------------------------------------------------
Last Update Date | 01/08/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARR. # 119 KM. 30.7 BO. HOYAMALA
-----------------------------------------------------
City | SAN SEBASTIAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00685
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-216-1507
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | HC 8 BOX 80353
-----------------------------------------------------
City | SAN SEBASTIAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00685-8803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-216-1507
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 16973
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------