Provider Demographics
NPI:1992968580
Name:JIMENEZ LUQUIS, ELIZBETH (MSW)
Entity type:Individual
Prefix:
First Name:ELIZBETH
Middle Name:
Last Name:JIMENEZ LUQUIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GG-11 C-30 URB CASTELLANA GARDENS
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1913
Mailing Address - Country:US
Mailing Address - Phone:787-365-4313
Mailing Address - Fax:
Practice Address - Street 1:289 LA CUMBRE
Practice Address - Street 2:CALLE LOS ROBLES
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5532
Practice Address - Country:US
Practice Address - Phone:787-365-4313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR156541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical