MEDICARE: DR. ANDRES JIMENEZ M.D.

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	2083C0008X	Clinical Informatics Physician	ME152696	FL
2	2083P0901X	Public Health & General Preventive Medicine Physician	ME152696	FL

General Provider Information

NPI Number	:	1689843534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDRES JIMENEZ M.D.

Provider Business Mailing Address
First Line	:	4 W LAS OLAS BLVD APT 2408
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-3091
Country	:	US
Telephone Number	:	516-743-1738
Fax Number	:	214-387-1079

Provider Business Practice Location Address
First Line	:	4 W LAS OLAS BLVD APT 2408
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-3091
Country	:	US
Telephone Number	:	516-743-1738
Fax Number	:	214-387-1079

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

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	02/23/2026

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