Provider Demographics
NPI:1073793949
Name:JIMENEZ, JUSTIN CARY (RN)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:CARY
Last Name:JIMENEZ
Suffix:
Gender:M
Credentials:RN
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Mailing Address - Street 1:1521 LENOX AVE
Mailing Address - Street 2:APT 303
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3369
Mailing Address - Country:US
Mailing Address - Phone:305-804-7210
Mailing Address - Fax:
Practice Address - Street 1:1613 HARRISON PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2896
Practice Address - Country:US
Practice Address - Phone:800-437-2672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2022-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL9198713367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered