Provider Demographics
NPI:1932409265
Name:JIMENEZ-PEREZ, SONIA N (LPN)
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:N
Last Name:JIMENEZ-PEREZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 STREET BO CAMUY ARRIBA
Mailing Address - Street 2:HC-02 BOX 8747
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00678
Mailing Address - Country:US
Mailing Address - Phone:787-383-2859
Mailing Address - Fax:
Practice Address - Street 1:129 STREET ANTIGUO HOSPITAL DE DISTRITO-ASSMCA
Practice Address - Street 2:COTTO STATIO BOX 9550
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-3552
Practice Address - Fax:787-879-8633
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21666164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse