Provider Demographics
NPI:1114992021
Name:JIMENEZ, DONA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DONA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-5489
Mailing Address - Country:US
Mailing Address - Phone:407-665-3329
Mailing Address - Fax:
Practice Address - Street 1:400 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5496
Practice Address - Country:US
Practice Address - Phone:407-665-3341
Practice Address - Fax:407-665-3213
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2088742363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner