Provider Demographics
NPI:1588936322
Name:LIMAS, JESUS JACINTO JR
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:JACINTO
Last Name:LIMAS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 OTATE CT
Mailing Address - Street 2:
Mailing Address - City:RIO RICO
Mailing Address - State:AZ
Mailing Address - Zip Code:85648-1900
Mailing Address - Country:US
Mailing Address - Phone:520-275-9542
Mailing Address - Fax:
Practice Address - Street 1:240 OTATE CT
Practice Address - Street 2:
Practice Address - City:RIO RICO
Practice Address - State:AZ
Practice Address - Zip Code:85648-1900
Practice Address - Country:US
Practice Address - Phone:520-275-9542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies