Provider Demographics
NPI:1225489560
Name:JIMENEZ DE ARMAS, ANYSLEN
Entity Type:Individual
Prefix:
First Name:ANYSLEN
Middle Name:
Last Name:JIMENEZ DE ARMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 TERRANCE LN
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-3428
Mailing Address - Country:US
Mailing Address - Phone:786-603-2315
Mailing Address - Fax:
Practice Address - Street 1:244 TERRANCE LN
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-3428
Practice Address - Country:US
Practice Address - Phone:786-603-2315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-55322106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician