Provider Demographics
NPI:1801861539
Name:OYOLA NIEVES, PEDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:
Last Name:OYOLA 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:PMB 170 FOREST HILLS
Mailing Address - Street 2:A8 CALLE MARGINAL
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-0000
Mailing Address - Country:US
Mailing Address - Phone:787-399-0884
Mailing Address - Fax:787-786-7460
Practice Address - Street 1:73 EDIFICIO MEDICO SANTA CRUZ
Practice Address - Street 2:SUITE 416
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-786-7460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR61572084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR27422Medicare ID - Type UnspecifiedMEDICARE CARRIER IN PR