Provider Demographics
NPI:1922319003
Name:BLANDON, JIMENA AMPARO (MD)
Entity Type:Individual
Prefix:DR
First Name:JIMENA
Middle Name:AMPARO
Last Name:BLANDON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:975 BAPTIST WAY
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7600
Mailing Address - Country:US
Mailing Address - Phone:786-243-8073
Mailing Address - Fax:786-243-8074
Practice Address - Street 1:13500 N KENDALL DR
Practice Address - Street 2:SUITE 131
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1515
Practice Address - Country:US
Practice Address - Phone:305-388-5222
Practice Address - Fax:305-388-5660
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2017-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME119287207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLUPIN FL0017827-A150OtherFLORIDA STATE OF HEALTH