Provider Demographics
NPI:1558488320
Name:JIMENEZ, AURA HELENA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AURA
Middle Name:HELENA
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13792 SW 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3031
Mailing Address - Country:US
Mailing Address - Phone:305-221-1702
Mailing Address - Fax:305-221-1154
Practice Address - Street 1:13792 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-3031
Practice Address - Country:US
Practice Address - Phone:305-221-1702
Practice Address - Fax:305-221-1154
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN116211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice