Provider Demographics
NPI:1639580210
Name:JIMENEZ OCASIO, JASON JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:JOSE
Last Name:JIMENEZ OCASIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CALLE GAUTIER BENITEZ STE 6838
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-5500
Mailing Address - Country:US
Mailing Address - Phone:787-438-5811
Mailing Address - Fax:
Practice Address - Street 1:232 CALLE MARIA
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-2774
Practice Address - Country:US
Practice Address - Phone:787-438-5811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR217302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology