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Individual

LAWRENCE CORONEL JIMENEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
760 EAST AVE BLDG 3911, PENSACOLA, FL 32508
(850) 452-8970
(850) 452-8978
Mailing address
1800 BROWN RD, PENSACOLA, FL 32508-7003
(619) 944-5641
(850) 452-8978

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
04/28/2013
Last updated
08/16/2018
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