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General NPI Number Information
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NPI Number | 1962131565
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Entity Type | Individual
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Provider Name | MELISSA MARIE OWEN JIMENEZ MD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | URB VILLA LOS SANTOS, V1 CALLE 16
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City | ARECIBO
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State | PR
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Zip | 00612-3112
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Country | US
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Telephone | 787-879-1585
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Fax | 787-815-2929
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Provider Business Mailing Address
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Address Line | URB QUINTAS DEL RIO CALLE SENDA DE LA POSADA N10
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City | BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-671-2505
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 23872
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License Number State | PR
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