Provider Demographics
NPI:1174132955
Name:CANDELARIA JIMENEZ, ADRIANA CAROLINA
Entity type:Individual
Prefix:
First Name:ADRIANA CAROLINA
Middle Name:
Last Name:CANDELARIA JIMENEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:C
Other - Last Name:CANDELARIA JIMENEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:300 AXIS DR APT 216
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-0079
Mailing Address - Country:US
Mailing Address - Phone:787-604-7136
Mailing Address - Fax:
Practice Address - Street 1:231 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1821
Practice Address - Country:US
Practice Address - Phone:502-629-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY60509207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine