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NPI 1811482995

NPI 1811482995 : ANGELIMAR DE JESUS JIMENEZ RD : WASHINGTON, DC

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General NPI Number Information
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    NPI Number           |    1811482995
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    Entity Type          |    Individual 
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    Provider Name        |    ANGELIMAR DE JESUS JIMENEZ RD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/29/2018
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    Last Update Date     |    06/29/2018
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Provider Practice Location Address
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    Address Line         |    50 IRVING ST NW 
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20422-0001
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    Country              |    US
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    Telephone            |    202-745-8190
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7522 BURDETTE WAY 
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    City                 |    BELTSVILLE
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    State                |    MD
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    Zip                  |    20705-6314
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    Country              |    US
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    Telephone            |    301-512-8739
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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        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    
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    License Number State |    
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