Provider Demographics
NPI:1164006151
Name:NIEVES, AMELIA
Entity Type:Individual
Prefix:MRS
First Name:AMELIA
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 1:312 CALLE 32
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4721
Mailing Address - Country:US
Mailing Address - Phone:787-749-0125
Mailing Address - Fax:787-749-0125
Practice Address - Street 1:312 CALLE 32
Practice Address - Street 2:URB. VILLA NEVAREZ
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4721
Practice Address - Country:US
Practice Address - Phone:787-749-0125
Practice Address - Fax:787-749-0125
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1546183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist