MEDICARE: DR. HARRY O JIMENEZ MD

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	4171	PR

General Provider Information

NPI Number	:	1497782551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY O JIMENEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 4211
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00958-1211
Country	:	US
Telephone Number	:	787-600-1051
Fax Number	:	787-520-9750

Provider Business Practice Location Address
First Line	:	1667 CALLE VERBENA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00927-6230
Country	:	US
Telephone Number	:	787-600-1051
Fax Number	:	787-520-9750

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	10/29/2024

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