Individual
DR. SANTIAGO JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 549-0677
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 549-0677
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
BP10024058
TX
2085R0202X
Diagnostic Radiology Physician
Primary
ME94727
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
11/17/2005
Last updated
01/12/2024
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