NPIMap

Individual provider Active NPI

Guillermo Jesus Jimenez, PA

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1972904324
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108110 Issued in FL
Practice address
9240 SW 72ND St Ste 241
Miami, FL 33173-3265
Phone
(305) 271-1919
Fax
(786) 271-1911
NPI assigned
Sep 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9108110 FL Primary

Addresses

Primary practice location

9240 SW 72ND St Ste 241
Miami, FL 33173-3265

Mailing address

10810 SW 126TH Ave
Miami, FL 33186-3749
Phone (786) 423-3357

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150303000701 FL Practitioner - Physician Assistant 1456677889 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Victor Lopez de Mendoza, MD PLLCGroup PAC ID 3274718226, 8 clinicians

Practice addresses (Care Compare)

10810 SW 126TH Ave
Miami, FL 33186-3749
Phone (786) 423-3357

7031 SW 62 Ave
South Miami, FL 33143-4701
Phone (305) 284-7500

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022
  • Larkin Community Hospital Hospital, South Miami, FL, CCN 100181
  • Keralty Hospital Hospital, Miami, FL, CCN 100284
  • HCA Florida Mercy Hospital Hospital, Plantation, FL, CCN 100167
  • Larkin Community Hospital Palm Springs Campus Hospital, Hialeah, FL, CCN 100050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PAT9108110FLMDPhysician Assistant

Organizations & group practices 4

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1972904324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 SW 126TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331863749",
            "telephone_number": "786-423-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 SW 72ND ST STE 241",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733265",
            "telephone_number": "305-271-1919",
            "fax_number": "786-271-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "GUILLERMO",
        "middle_name": "JESUS",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.