Provider Demographics
NPI:1811108418
Name:JIMENEZ, SALVADOR (MD)
Entity type:Individual
Prefix:
First Name:SALVADOR
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23 CALLE EL VIGIA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-2988
Mailing Address - Country:US
Mailing Address - Phone:787-840-4030
Mailing Address - Fax:787-840-4310
Practice Address - Street 1:917 AVE TITO CASTRO
Practice Address - Street 2:CLINICAS EXTERNAS HOSPITAL SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4717
Practice Address - Country:US
Practice Address - Phone:787-840-4030
Practice Address - Fax:787-840-4310
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR8605208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)