Organization
JESUS L JIMENEZ BARREDO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESUS L JIMENEZ BARREDO MD (PRESIDENT)
(517) 944-1914
Entity
Organization
Contact information
Practice address
16520 NW 77TH PL, MIAMI LAKES, FL 33016-3417
(517) 944-1914
(786) 558-4216
Mailing address
16520 NW 77TH PL, MIAMI LAKES, FL 33016-3417
(517) 944-1914
(786) 558-4216
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
ME101359
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME101359
FLORIDA LICENSE
FL
Enumeration date
10/24/2011
Last updated
10/24/2011
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