Provider Demographics
NPI:1194332171
Name:JIMENEZ, GABY
Entity type:Individual
Prefix:
First Name:GABY
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 ALTON RD STE 830
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4558
Mailing Address - Country:US
Mailing Address - Phone:305-532-0065
Mailing Address - Fax:305-532-9793
Practice Address - Street 1:4308 ALTON RD STE 830
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4558
Practice Address - Country:US
Practice Address - Phone:305-532-0065
Practice Address - Fax:305-532-9793
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant