Provider Demographics
NPI:1629221825
Name:JIMENEZ CASTRO, FERNANDO
Entity Type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:
Last Name:JIMENEZ CASTRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 254 PO BOX 4960
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4960
Mailing Address - Country:US
Mailing Address - Phone:787-375-5119
Mailing Address - Fax:787-258-5487
Practice Address - Street 1:SABOYA A-4
Practice Address - Street 2:VILLA DEL REY
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-7113
Practice Address - Country:US
Practice Address - Phone:787-375-5119
Practice Address - Fax:787-258-5487
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist