Active NPI
Lisannette Marie Jimenez, OTA
- Specialist
- Cidra, PR
National Provider Identifier
1174733638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 482
- Practice address
- Bo. Ceiba Parcelas Hevia # 8
Cidra, PR 00739 - Phone
- (939) 639-6856
- NPI assigned
- May 23, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 482 | PR | Primary |
Addresses
Primary practice location
Bo. Ceiba Parcelas Hevia # 8
Cidra, PR 00739
Mailing address
Bo. Ceiba Casa 8
Cidra, PR 00739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 482 | PR | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174733638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BO. CEIBA CASA 8",
"city": "CIDRA",
"state": "PR",
"postal_code": "00739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BO. CEIBA PARCELAS HEVIA # 8",
"city": "CIDRA",
"state": "PR",
"postal_code": "00739",
"telephone_number": "939-639-6856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "LISANNETTE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PR",
"license": "482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cidra, PR
- Inter American University of Puerto Rico
- Internal Council Medicine Enhance, PSC
- Isleep Diagnostics Corp
- Jason Luis Izquierdo, MD
- Carmen Yaritza Jimenez, LIC.
- Catherine Johnson-Ramos, RN
- Jorge Calderon Inc CP
- Anarda Justiniano, M.D.
- La Montana Medical Group, Inc.
- Laboratorio Clinico Bacteriologico Torval Agostini Inc (Laboratorio Clinico Bacteriologico Torval Agostini)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.