Provider Demographics
NPI:1659391928
Name:NIEVES-CURBELO, DIANA (PH)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:NIEVES-CURBELO
Suffix:
Gender:F
Credentials:PH
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 976
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-0976
Mailing Address - Country:US
Mailing Address - Phone:787-895-0919
Mailing Address - Fax:787-895-0919
Practice Address - Street 1:2621 ROAD # 113 KM 11.6
Practice Address - Street 2:BO. CACAO
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-895-1001
Practice Address - Fax:787-895-1001
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3689OtherLICENCE