Individual
RODOLFO JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1260 S CAMPBELL RD, GREEN VALLEY, AZ 85614
(520) 625-3691
(520) 625-2894
Mailing address
1260 S CAMPBELL AVE, BLDG. 2, GREEN VALLEY, AZ 85614-0503
(520) 407-5606
(520) 625-8504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2763
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113799
MEDICARE ID
AZ
05
—
139081
—
AZ
Enumeration date
05/26/2005
Last updated
01/31/2020
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