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NPI Code Detail

MEDICARE: LISANDRA JIMENEZ

MEDICARE: LISANDRA JIMENEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language AssistantSI4163FL

General Provider Information

NPI Number : 1396389102
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISANDRA JIMENEZ
Provider Business Mailing Address
First Line : 1850 FOREST HILL BLVD STE 100
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33406-6056
Country : US
Telephone Number : 561-328-8312
Fax Number : 561-584-5033
Provider Business Practice Location Address
First Line : 1850 FOREST HILL BLVD STE 100
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33406-6056
Country : US
Telephone Number : 561-328-8312
Fax Number : 561-584-5033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2019
Last Update Date : 11/05/2019

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Directions to “ LISANDRA JIMENEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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