Pena- Jimenez, Awilda M

Pena- Jimenez, Awilda M is an sole proprietor health care provider with primary practice located at 7101 W Mcnab Rd Ste 101 , Tamarac FL 33321-5351. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Pena- Jimenez, Awilda M can be contacted via phone (954) 722-5600.

Contact Information

Primary practice address
7101 W Mcnab Rd Ste 101 Tamarac FL 33321-5351
Phone: (954) 722-5600
Fax: (855) 252-2845
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME107050 Florida

Profile Details

NPI number 1821282211
LBN Legal business name Pena- Jimenez, Awilda M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2007
Last updated Mar 7th, 2023 - about 3 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 1821282211 NPPES
Florida MEDICAID 002818900

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