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NPI Code Detail

MEDICARE: MARTHA REYES JIMENEZ

MEDICARE: MARTHA REYES 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
1104100000XSocial WorkerCBHCMS0100698FL
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1922346691
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA REYES JIMENEZ
Provider Business Mailing Address
First Line : 9581 FONTAINEBLEAU BLVD APT 609
Second Line :
City : MIAMI
State : FL
Zip : 33172-6850
Country : US
Telephone Number : 786-645-0095
Fax Number :
Provider Business Practice Location Address
First Line : 15924 SW 92ND AVE
Second Line :
City : PALMETTO BAY
State : FL
Zip : 33157-1842
Country : US
Telephone Number : 305-964-5824
Fax Number : 786-452-1200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2013
Last Update Date : 07/15/2025

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Directions to “ MARTHA REYES JIMENEZ ” Practice Location

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