Provider Demographics
NPI:1477754000
Name:NIEVES, GIL J (MD)
Entity Type:Individual
Prefix:DR
First Name:GIL
Middle Name:J
Last Name:NIEVES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PMB 195
Mailing Address - Street 2:35 CALLE JUAN C. BORBON SUITE 67
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-464-3130
Mailing Address - Fax:787-781-3131
Practice Address - Street 1:CONSOLIDATED MEDICAL PLAZA, AVE. GAUTIER BENITEZ
Practice Address - Street 2:SUITE 208
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-8682
Practice Address - Fax:787-743-5474
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2011-03-08
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Provider Licenses
StateLicense IDTaxonomies
PR15919208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0023624Medicare PIN