# CARLOS E. JIMENEZ HUYKE MD PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700056702
- **Authorized official:** MR. CARLOS E JIMENEZ MD (PRESIDENT)
- **Authorized official phone:** (787) 852-1358

## Contact information

- **Practice address:** SUITE A-2 PROFESSIONAL PLAZA, CARR 908 KM 0.4 BO. TEJAS, HUMACAO, PR 00792
- **Practice address phone:** (787) 852-1358
- **Practice address fax:** (787) 850-1388
- **Mailing address:** PMB 500, 100 GRAND POSEO BLVD 112, SAN JUAN, PR 00926
- **Mailing address phone:** (787) 283-0804
- **Mailing address fax:** (787) 761-5764

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 14798 | PR | Yes |

## Other

- **Enumeration date:** 03/05/2008
- **Last updated:** 12/04/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 14798 | PR MEDICAL LICENSE | PR |