Jimenez Rehabilitation LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

JIMENEZ REHABILITATION LLC

Doing business as

Fountain Of Youth Therapies

Practice address

1603 S Hiawassee Rd Ste 105
Orlando, FL 32835-6437

Phone

(407) 508-0768

NPI assigned

Jun 9, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Sidney L Jimenez, MM 45280NPI 1649958869

Title

Licensed Medical Massage Therapist

Phone

(407) 508-0768

Specialties & licenses 4

Addresses

Other names 1

• Fountain Of Youth Therapies Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sidney Leslie Jimenez, MA 93477

  • Massage Therapist
  • Orlando, FL
  • NPI 1649958869
  NPD Authorized official

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1972287027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 S HIAWASSEE RD STE 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356437",
            "telephone_number": "407-508-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 S HIAWASSEE RD STE 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356437",
            "telephone_number": "407-508-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMENEZ REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED MEDICAL MASSAGE THERAPIST",
        "authorized_official_telephone_number": "407-508-0768",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MM 45280"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WM1400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain Of Youth Therapies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danny Jijon, CRNA
• Zeshan A Jilani, MD
• Proviess Jiles
• Ramon Antonio Jimenez Genao, MD
• Yordan Jimenez Perez
• Joesmarie Jimenez Tollinchi
• Johanne Jimenez-Alexander, LMHC
• Jose Rafael Jimenez-Garcia, MD
• Act'a Jimenez
• Adriana Jimenez

• Massage Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.