Provider Demographics
NPI:1407835770
Name:JIMENEZ, CRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 03 9888 CARR 111 KM33.5
Mailing Address - Street 2:BO PUEBLO
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-9888
Mailing Address - Country:US
Mailing Address - Phone:787-249-7431
Mailing Address - Fax:
Practice Address - Street 1:HC 03 9888
Practice Address - Street 2:BO PUEBLO
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-9888
Practice Address - Country:US
Practice Address - Phone:787-249-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14485208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics