Individual
AWILDA M PENA- JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D,
Contact information
Practice address
7101 W MCNAB RD STE 101, TAMARAC, FL 33321-5351
(954) 722-5600
(855) 252-2845
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME107050
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002818900
—
FL
Enumeration date
08/29/2007
Last updated
03/03/2026
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