Individual
ANTHONY JOHN JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
403 S KINGS AVE STE 201, BRANDON, FL 33511-5962
(813) 872-4992
(813) 864-4030
Mailing address
403 S KINGS AVE, STE 201, BRANDON, FL 33511-5962
(813) 872-4492
(813) 490-9635
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA3216
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290370901
—
FL
01
—
970022306
RAILROAD MEDICARE
—
Enumeration date
04/13/2006
Last updated
09/05/2019
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