Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 11046 | PR |
NPI | 1609841667 |
---|---|
Provider Name | Dr. Carlos E Jimenez |
First Address | Guaynabo, PR 00969-5375 |
Second Address | San Juan, PR 00907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 01/10/2012 |