Provider Demographics
NPI:1033862677
Name:NIEVES, YOANDRA (PHD)
Entity Type:Individual
Prefix:
First Name:YOANDRA
Middle Name:
Last Name:NIEVES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 LAKE HERITAGE CIR APT 516
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-8279
Mailing Address - Country:US
Mailing Address - Phone:787-597-1180
Mailing Address - Fax:
Practice Address - Street 1:1101 MIRANDA LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-0769
Practice Address - Country:US
Practice Address - Phone:407-494-3787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth