Provider Demographics
NPI:1871549840
Name:GILBERTO JIMENEZ MD INC
Entity type:Organization
Organization Name:GILBERTO JIMENEZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GILBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-364-9949
Mailing Address - Street 1:19346 SW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2752
Mailing Address - Country:US
Mailing Address - Phone:305-364-9949
Mailing Address - Fax:305-364-0927
Practice Address - Street 1:1435 W 49TH PL STE 306
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3147
Practice Address - Country:US
Practice Address - Phone:305-364-9949
Practice Address - Fax:305-364-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06097OtherBC BS OF FLORIDA
FL263490200Medicaid
FLK7446Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO
FLE6040BMedicare ID - Type UnspecifiedGILBERTO JIMENEZ MD
FL263490200Medicaid