Individual provider Active NPI

William Fernando Jimenez, M.D.

  • General Practice Physician
  • Haines City, FL
National Provider Identifier
1659781912
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN798 Issued in FL
Practice address
105 S Dixie Dr
Haines City, FL 33844-2844
Phone
(863) 421-1190
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 18740 PR
General Practice Physician 208D00000X ACN798 FL Primary

Addresses

Primary practice location

105 S Dixie Dr
Haines City, FL 33844-2844

Mailing address

105 S Dixie Dr
Haines City, FL 33844-2844
Phone (863) 421-1190

Other practice location 1

Carr 128 Km 1.0
Yauco, Puerto Rico 00698
UM
Phone (787) 856-1000 ext. 2157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160627000531 TX Practitioner - Emergency Medicine 4385934629 Reassigns benefits to 1 organization
I20160921000330 FL Practitioner - General Practice 4385934629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Physicians LLCGroup PAC ID 9234554643, 30 clinicians

Practice addresses (Care Compare)

3240 S Florida Ave
Lakeland, FL 33803-4574

3242 S Florida Ave
Lakeland, FL 33803-4574
Phone (863) 644-0800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN798FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Physicians, LLC CurrentSince Jan 1, 2024 Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince May 24, 2016 Accepting new patients
Rad Nucs LLC Past Accepting new patients
Yauco Healthcare Corporation Past Accepting new patients
Orlando Family Physicians, LLC General Practice Past Accepting new patients

Locations

101 S Dixie Dr
Haines City, FL 33844
Phone (863) 216-6595

105 S Dixie Dr
Haines City, FL 33844
Phone (863) 421-1190

3240 S Florida Ave
Ste 101
Lakeland, FL 33803
Phone (863) 644-7337

3240 S Florida Ave
Ste 100
Lakeland, FL 33803
Phone (863) 646-4000

425 W Colonial Dr
Ste 303
Orlando, FL 32804
Phone (321) 332-6947

6900 Tavistock Lakes Blvd
Ste 300
Orlando, FL 32827
Phone (321) 332-6947

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: william.jimenez.1@27472.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1659781912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S DIXIE DR",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338442844",
            "telephone_number": "863-421-1190",
            "fax_number": "833-450-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S DIXIE DR",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338442844",
            "telephone_number": "863-421-1190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carr 128 Km 1.0",
            "address_purpose": "LOCATION",
            "city": "Yauco",
            "state": "Puerto Rico",
            "postal_code": "00698",
            "country_code": "UM",
            "telephone_number": "787-856-1000 x2157",
            "country_name": "United States Minor Outlying Islands",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "WILLIAM",
        "middle_name": "FERNANDO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18740",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

Verify at the official NPI Registry.