Individual
TALIA B JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2804 DEL PRADO BLVD S STE 1, CAPE CORAL, FL 33904-7252
(239) 540-9555
(239) 549-0875
Mailing address
2717 SW 11TH AVE, CAPE CORAL, FL 33914-4118
(786) 342-9555
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024036700
—
FL
Enumeration date
05/09/2018
Last updated
06/11/2019
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