Provider Demographics
NPI:1760774426
Name:JIMENEZ, YUNET
Entity Type:Individual
Prefix:
First Name:YUNET
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 SW 8TH ST
Mailing Address - Street 2:SUITE#45
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2900
Mailing Address - Country:US
Mailing Address - Phone:305-646-1220
Mailing Address - Fax:305-646-1837
Practice Address - Street 1:9600 SW 8TH ST
Practice Address - Street 2:SUITE#45
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2900
Practice Address - Country:US
Practice Address - Phone:305-646-1220
Practice Address - Fax:305-646-1837
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC9127111NR0400X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC9127OtherHEALTH CARE CLINIC DIV
FL274527614OtherEIN