Provider Demographics
NPI:1376730846
Name:SONIA M JIMENEZ -VICTORES ENDOCRINOLOGY LLC
Entity Type:Organization
Organization Name:SONIA M JIMENEZ -VICTORES ENDOCRINOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:MATILDE
Authorized Official - Last Name:JIMENEZ-VICTORES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-820-4426
Mailing Address - Street 1:315 W 49TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3715
Mailing Address - Country:US
Mailing Address - Phone:305-820-4426
Mailing Address - Fax:305-820-4436
Practice Address - Street 1:315 W 49TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3715
Practice Address - Country:US
Practice Address - Phone:305-820-4426
Practice Address - Fax:305-820-4436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79874207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2038Medicare PIN