Provider Demographics
NPI:1609962232
Name:CUMBA, NIXALIZ (MD)
Entity Type:Individual
Prefix:DR
First Name:NIXALIZ
Middle Name:
Last Name:CUMBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 CALLE TEGUCIGALPA
Mailing Address - Street 2:URB LAS AMERICAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-2329
Mailing Address - Country:US
Mailing Address - Phone:787-615-7822
Mailing Address - Fax:
Practice Address - Street 1:978 CALLE TEGUCIGALPA
Practice Address - Street 2:URB LAS AMERICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2329
Practice Address - Country:US
Practice Address - Phone:787-615-7822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16285208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice