Provider Demographics
NPI:1033110275
Name:ORTEGA NIEVES, HIRAM (MD)
Entity Type:Individual
Prefix:
First Name:HIRAM
Middle Name:
Last Name:ORTEGA NIEVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 998
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-0998
Mailing Address - Country:US
Mailing Address - Phone:787-868-5455
Mailing Address - Fax:787-868-5455
Practice Address - Street 1:93 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3115
Practice Address - Country:US
Practice Address - Phone:787-868-5455
Practice Address - Fax:787-868-5455
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8159208000000X, 208D00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No171100000XOther Service ProvidersAcupuncturist