Individual
CARLOS ALBERTO JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
251 MAITLAND AVE STE 104, ALTAMONTE SPRINGS, FL 32701-4913
(407) 557-2165
Mailing address
2201 NORTH BLVD W, DAVENPORT, FL 33837-8990
(863) 419-0688
(863) 419-9547
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
PA9100035
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290861100
—
FL
Enumeration date
01/18/2007
Last updated
05/06/2023
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