Jimenez, Jessica Sarah

Jimenez, Jessica Sarah is an individual health care provider with primary practice located at 1075 Mason Ave , Daytona Beach FL 32117-4611. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jimenez, Jessica Sarah can be contacted via phone (386) 255-4596.

Contact Information

Primary practice address
1075 Mason Ave Daytona Beach FL 32117-4611
Phone: (386) 255-4596
Fax: (386) 258-3561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9117307 Florida

Profile Details

NPI number 1306986898
LBN Legal business name Jimenez, Jessica Sarah
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Feb 7th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306986898 NPPES
Florida MEDICAID 118769300

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