Provider Demographics
NPI:1770705360
Name:JIMENEZ, JORGE LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:LUIS
Last Name:JIMENEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:CLINICA LAS AMERICAS
Mailing Address - Street 2:AVE. F. D. ROOSEVELT #400, SUITE 410
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-753-6414
Mailing Address - Fax:787-763-7125
Practice Address - Street 1:CLINICA LAS AMERICAS
Practice Address - Street 2:AVE. F. D. ROOSEVELT #400, SUITE 410
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-753-6414
Practice Address - Fax:787-763-7125
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR42282084D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging