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Organization

IMAGINE PEDIATRICS OF FLORIDA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAYMOND JIMINEZ (GENERAL MANAGER)
(833) 208-7770
Entity
Organization

Contact information

Practice address
3109 W DR MARTIN LUTHER KING JR BLVD STE 350, TAMPA, FL 33607-6208
(833) 208-7770
Mailing address
PO BOX 34103, BELFAST, ME 04915-0619
(833) 208-7770

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104100000X
Social Worker
106H00000X
Marriage & Family Therapist
133V00000X
Registered Dietitian
183500000X
Pharmacist
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician
Primary
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP0200X
Pediatric Nurse Practitioner
363LP0222X
Critical Care Pediatric Nurse Practitioner

Other

Enumeration date
10/19/2022
Last updated
08/18/2025
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