Provider Demographics
NPI:1043049141
Name:JIMENEZ FERRO, NIUVYS
Entity type:Individual
Prefix:
First Name:NIUVYS
Middle Name:
Last Name:JIMENEZ FERRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10126 E SLIGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-9225
Mailing Address - Country:US
Mailing Address - Phone:813-564-5473
Mailing Address - Fax:
Practice Address - Street 1:10126 E SLIGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-9225
Practice Address - Country:US
Practice Address - Phone:813-564-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-362088106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician