Provider Demographics
NPI:1750778098
Name:XIMENARD, INC.
Entity type:Organization
Organization Name:XIMENARD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:XIMENA
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:786-346-6799
Mailing Address - Street 1:7600 S RED RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5428
Mailing Address - Country:US
Mailing Address - Phone:786-346-6799
Mailing Address - Fax:
Practice Address - Street 1:7600 S RED RD
Practice Address - Street 2:SUITE 215
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5428
Practice Address - Country:US
Practice Address - Phone:786-346-6799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3557133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty