Individual provider Active NPI

Norma Ivonne Jimenez, PA

  • Pediatrics Physician
  • Hialeah, FL
National Provider Identifier
1417085523
Registry record updated Sep 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
PA9101494 Issued in FL
Practice address
3416 W 84TH St
Suite 100
Hialeah, FL 33018-4933
Phone
(305) 826-9449
Fax
(305) 828-1255
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X PA9101494 FL Primary

Addresses

Primary practice location

3416 W 84TH St
Suite 100
Hialeah, FL 33018-4933

Mailing address

3567 W 71St Ter
Hialeah, FL 33018-7105
Phone (786) 200-4232

Other identifiers 1

IdentifierTypeStateIssuer
291822600MedicaidFL

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9101494FLMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316908800000",
    "number": "1417085523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3567 W 71ST TER",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330187105",
            "telephone_number": "786-200-4232",
            "fax_number": "305-394-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 W 84TH ST",
            "address_2": "SUITE 100",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330184933",
            "telephone_number": "305-826-9449",
            "fax_number": "305-828-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "NORMA",
        "middle_name": "IVONNE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "PA9101494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291822600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.