Provider Demographics
NPI:1093401861
Name:NIEVES, HELGA EDMEE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:HELGA
Middle Name:EDMEE
Last Name:NIEVES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ALTOS DE PANORAMA APT. 832
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-4434
Mailing Address - Country:US
Mailing Address - Phone:787-642-2016
Mailing Address - Fax:787-279-8153
Practice Address - Street 1:URB. REXVILLE L-2 CALLE 9
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-2512
Practice Address - Country:US
Practice Address - Phone:787-797-3969
Practice Address - Fax:787-279-8153
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR04931060Medicaid