Basic Information
| Provider Information | |||||||||
| NPI: | 1861713943 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JIMENEZ | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1445 | ||||||||
| Address2: | |||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330611445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619813793 | ||||||||
| FaxNumber: | 9542806788 | ||||||||
| Practice Location | |||||||||
| Address1: | 5901 COLONIAL DR | ||||||||
| Address2: | SUITE 311 | ||||||||
| City: | MARGATE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330635675 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614833989 | ||||||||
| FaxNumber: | 9544291759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2010 | ||||||||
| LastUpdateDate: | 10/27/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | ME106944 | FL | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.