Provider Demographics
NPI:1851164552
Name:ROBERT JIMENEZ, CHRISTOPHER (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:ROBERT JIMENEZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EXT. VILLA RICA
Mailing Address - Street 2:CALLE RITA AA30
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-325-3630
Mailing Address - Fax:
Practice Address - Street 1:EXT. VILLA RICA
Practice Address - Street 2:CALLE RITA AA30
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-0095
Practice Address - Country:US
Practice Address - Phone:787-325-3630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily