Provider Demographics
NPI:1023551348
Name:JIMENEZ, GLORIBEL
Entity Type:Individual
Prefix:
First Name:GLORIBEL
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SHADY PINE WAY
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33415-8906
Mailing Address - Country:US
Mailing Address - Phone:732-857-1191
Mailing Address - Fax:
Practice Address - Street 1:501 SHADY PINE WAY
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33415-8906
Practice Address - Country:US
Practice Address - Phone:732-857-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-19
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator