Provider Demographics
NPI:1962131565
Name:OWEN JIMENEZ, MELISSA MARIE (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:OWEN JIMENEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:URB QUINTAS DEL RIO
Mailing Address - Street 2:CALLE SENDA DE LA POSADA N10
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-671-2505
Mailing Address - Fax:
Practice Address - Street 1:V1 CALLE 16
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-3112
Practice Address - Country:US
Practice Address - Phone:787-979-1585
Practice Address - Fax:787-815-2929
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR23872208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics