Provider Demographics
NPI:1013165141
Name:RIVERA-JIMENEZ, JOSE DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:DAVID
Last Name:RIVERA-JIMENEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7754 BAY ST
Mailing Address - Street 2:SUITE 6&7
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3427
Mailing Address - Country:US
Mailing Address - Phone:772-589-3000
Mailing Address - Fax:772-589-3003
Practice Address - Street 1:7754 BAY ST
Practice Address - Street 2:SUITE 6&7
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3427
Practice Address - Country:US
Practice Address - Phone:772-589-3000
Practice Address - Fax:772-589-3003
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR18396207R00000X
FLME128230207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine