Provider Demographics
NPI:1083349716
Name:NIEVES, REBECA
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:NIEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CALLE GAUTIER BENITEZ UNIT 7434
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-5500
Mailing Address - Country:US
Mailing Address - Phone:812-595-2888
Mailing Address - Fax:
Practice Address - Street 1:225 CALLE GAUTIER BENITEZ UNIT 7434
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5500
Practice Address - Country:US
Practice Address - Phone:812-595-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program