Individual
RAFAEL JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
302 W BASS ST, KISSIMMEE, FL 34741-5001
(407) 518-7999
(407) 518-9766
Mailing address
302 W BASS ST, KISSIMMEE, FL 34741-5001
(407) 518-7999
(407) 518-9766
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME0059612
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06920
WELLCARE
FL
01
—
10411101
CITRUS CARE
FL
01
—
2102311
GHI
—
05
—
251215700
—
FL
01
—
4380411
AETNA
FL
01
—
4724188
CIGNA
FL
Enumeration date
07/06/2006
Last updated
04/23/2014
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