Provider Demographics
NPI:1427156421
Name:RODRIGUEZ-JIMENEZ, HORACIO (MD)
Entity type:Individual
Prefix:
First Name:HORACIO
Middle Name:
Last Name:RODRIGUEZ-JIMENEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13067 N TELECOM PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0926
Mailing Address - Country:US
Mailing Address - Phone:813-779-6303
Mailing Address - Fax:888-977-1998
Practice Address - Street 1:13067 N TELECOM PKWY
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637
Practice Address - Country:US
Practice Address - Phone:813-779-6303
Practice Address - Fax:888-977-1998
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46575207R00000X, 208M00000X
FLME0061655208M00000X
FLME61655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18314OtherBCBS
FL371489600Medicaid
FLP00144054OtherRR MEDICARE
FLP00144054OtherRR MEDICARE
FL18314OtherBCBS