Provider Demographics
NPI:1851370548
Name:GARCIA-JIMENEZ, JOSE J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:J
Last Name:GARCIA-JIMENEZ
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:P.O. BOX 1537
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1537
Mailing Address - Country:US
Mailing Address - Phone:787-891-3373
Mailing Address - Fax:787-882-3642
Practice Address - Street 1:AVE. VICTORIA #536
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-3373
Practice Address - Fax:787-882-3642
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6712174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC82142Medicare UPIN
C82142Medicare UPIN