Provider Demographics
NPI:1215556329
Name:PENA GARCIA, JAIME ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ALEJANDRO
Last Name:PENA GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAIME
Other - Middle Name:ALEJANDRO
Other - Last Name:PENA-GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:625 19TH STREET SOUTH
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35249-5247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:625 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1900
Practice Address - Country:US
Practice Address - Phone:205-934-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program