Provider Demographics
NPI:1437465762
Name:SERVICIOS MEDICOS NIEVES LOPEZ
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS NIEVES LOPEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-423-7086
Mailing Address - Street 1:L2 CALLE 7
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-2220
Mailing Address - Country:US
Mailing Address - Phone:787-423-7086
Mailing Address - Fax:787-870-3756
Practice Address - Street 1:L2 CALLE 7
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-2220
Practice Address - Country:US
Practice Address - Phone:787-423-7086
Practice Address - Fax:787-870-3756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17673261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service