Provider Demographics
NPI:1659453553
Name:NIEVES, NORMA I (OPTHICIAN)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:I
Last Name:NIEVES
Suffix:
Gender:F
Credentials:OPTHICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CALLE BETANCES
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-2212
Mailing Address - Country:US
Mailing Address - Phone:787-896-0160
Mailing Address - Fax:787-896-0160
Practice Address - Street 1:30 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2212
Practice Address - Country:US
Practice Address - Phone:787-896-0160
Practice Address - Fax:787-896-0160
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR#467156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician