Provider Demographics
NPI:1649793944
Name:JIMENEZ, CLAUDIA (MD)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
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:VILLA DEL REY 2DA SEC
Mailing Address - Street 2:AVE LUIS MUNOZ MARIN ESQ CARLO MAGNO 2F6
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-704-0075
Mailing Address - Fax:
Practice Address - Street 1:VILLA DEL REY 2DA SEC
Practice Address - Street 2:AVE LUIS MUNOZ MARIN ESQ CARLO MAGNO 2F6
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-704-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23284208D00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1649793944Medicaid