Provider Demographics
NPI:1235296781
Name:NIEVES, ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:NIEVES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LAGUNA GARDENS SHOPPING CENTER
Mailing Address - Street 2:SUITE 250-B
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-791-7767
Mailing Address - Fax:787-791-7767
Practice Address - Street 1:LAGUNA GARDENS SHOPPING CENTER
Practice Address - Street 2:SUITE 250-B
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-791-7767
Practice Address - Fax:787-791-7767
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR68160OtherPIN SSS
PR9790136OtherPIN HUMANA
PRP-511OtherPIN IMC
PR22174NIOtherPIN MEDICARE OPTIMO
PR0022174Medicare PIN