Provider Demographics
NPI:1437252350
Name:NIEVES, RUBEN NEIL (OD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:NEIL
Last Name:NIEVES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 2 J-20
Mailing Address - Street 2:EXT HERMANAS DAVILA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-460-5937
Mailing Address - Fax:787-786-3548
Practice Address - Street 1:CALLE 2 J-20
Practice Address - Street 2:EXTENSION HERMANAS DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-460-5937
Practice Address - Fax:787-786-3548
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR589152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0058637OtherMEDICARE PTAN