Provider Demographics
NPI:1477663615
Name:FELIZ, NESTOR J (MD)
Entity Type:Individual
Prefix:
First Name:NESTOR
Middle Name:J
Last Name:FELIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1060
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637
Mailing Address - Country:US
Mailing Address - Phone:787-873-5946
Mailing Address - Fax:787-873-5946
Practice Address - Street 1:C/FRANCISCOM QUINONES #58
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637
Practice Address - Country:US
Practice Address - Phone:787-873-5946
Practice Address - Fax:787-873-5946
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR9500208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F08083Medicare UPIN