Provider Demographics
NPI:1124556048
Name:NIEVES, JOSE O (RRT)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:O
Last Name:NIEVES
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:1405 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-8043
Mailing Address - Country:US
Mailing Address - Phone:516-297-9793
Mailing Address - Fax:
Practice Address - Street 1:2435 US HIGHWAY 19 STE 300
Practice Address - Street 2:300
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34891-3904
Practice Address - Country:US
Practice Address - Phone:877-202-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT82142279P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Diagnostics