Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 675 | PR |
NPI | 1922664846 |
---|---|
Provider Name | Dr. Cassandra Liz Jimenez Fernandez |
First Address | Bayamon, PR 00956-2970 |
Second Address | Bayamon, PR 00956-2970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2019 |
Last Update Date | 08/07/2019 |