Provider Demographics
NPI:1497416192
Name:NIEVES, HECTOR MANUEL (THERAPIST)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:MANUEL
Last Name:NIEVES
Suffix:
Gender:M
Credentials:THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3641
Mailing Address - Country:US
Mailing Address - Phone:407-285-8528
Mailing Address - Fax:
Practice Address - Street 1:518 PEACHTREE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-6813
Practice Address - Country:US
Practice Address - Phone:407-730-7983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program