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General NPI Number Information
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NPI Number | 1982070306
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Entity Type | Individual
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Provider Name | ALFONSO JIMENEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 12/07/2024
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Provider Practice Location Address
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Address Line | 5153 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32504-8785
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Country | US
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Telephone | 646-893-9220
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Fax | 406-226-0543
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Provider Business Mailing Address
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Address Line | 3041 KNOTTY PINE DR
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City | PENSACOLA
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State | FL
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Zip | 32505-1853
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Country | US
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Telephone | 646-893-9220
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Fax | 406-226-0543
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 168159
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 168159
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 168159
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 296208
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME164737
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | ME164737
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 296208
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME164737
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License Number State | FL
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