Laura Marcela Marin Jimenez, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN20943 Issued in FL

Practice address

4039 13TH St
Saint Cloud, FL 34769-6772

Phone

(407) 892-1643

Fax

(407) 892-9143

NPI assigned

Sep 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1457751075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12418 NW 11TH LN # 2110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331822461",
            "telephone_number": "786-554-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696772",
            "telephone_number": "407-892-1643",
            "fax_number": "407-892-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN JIMENEZ",
        "first_name": "LAURA",
        "middle_name": "MARCELA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20943",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040171",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leland Mangrum
• Manna Home Health Care LLC
• Lizbeth Manoah, RN BSN IBCLC
• Ayah Mansour
• Minedith Marengo
• Karen B Marquez de Chourio
• Zulmarie Z Marquez Rijos
• Alexis Marquez
• Kristal Marie Marquez
• Kira Joann Marquith, MS

• General Practice Dentistry in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.