Provider Demographics
NPI:1770255903
Name:JIMENEZ, KATRINA (PA)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:JIMENEZ
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Gender:F
Credentials:PA
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Mailing Address - Street 1:14050 TOWN LOOP BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6190
Mailing Address - Country:US
Mailing Address - Phone:407-251-8800
Mailing Address - Fax:407-251-8801
Practice Address - Street 1:14050 TOWN LOOP BLVD STE 204
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6190
Practice Address - Country:US
Practice Address - Phone:407-251-8800
Practice Address - Fax:407-251-8801
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2022-04-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant