Provider Demographics
NPI:1770511131
Name:LOPEZ-NIEVES, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:LOPEZ-NIEVES
Suffix:
Gender:M
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:HC-4 BOX 18698
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-8824
Mailing Address - Country:US
Mailing Address - Phone:787-354-2452
Mailing Address - Fax:
Practice Address - Street 1:CARR.189 RAMAL 933 INTERIOR 0.9
Practice Address - Street 2:BARRIO MAMEY LL
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-8824
Practice Address - Country:US
Practice Address - Phone:787-354-2452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9513207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine