Provider Demographics
NPI:1275505943
Name:JIMENEZ, EVA N (RPH)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:N
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE 1A
Mailing Address - Street 2:ALTURAS DE BERWIND
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-2465
Mailing Address - Country:US
Mailing Address - Phone:787-257-0757
Mailing Address - Fax:787-752-2715
Practice Address - Street 1:COND BELAIR
Practice Address - Street 2:SUITE 2
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-4401
Practice Address - Country:US
Practice Address - Phone:787-782-1180
Practice Address - Fax:787-782-2765
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist