Provider Demographics
NPI:1093984213
Name:JIMENEZ-MESSON, CESAR
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:
Last Name:JIMENEZ-MESSON
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:CESAR
Other - Middle Name:
Other - Last Name:JIMENEZ-MESSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:M D
Mailing Address - Street 1:4939 AVE ISLA VERDE
Mailing Address - Street 2:TIFFANY COND. APTO 1001
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-5421
Mailing Address - Country:US
Mailing Address - Phone:787-268-7372
Mailing Address - Fax:787-268-7372
Practice Address - Street 1:4939 AVE ISLA VERDE
Practice Address - Street 2:TIFFANY COND. APTO 1001
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-5421
Practice Address - Country:US
Practice Address - Phone:787-268-7372
Practice Address - Fax:787-268-7372
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3115174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3115OtherMEDICAL LICENCE PUERTO RICO