Provider Demographics
NPI:1821338666
Name:NIEVES ALVAREZ, GIL A II
Entity Type:Individual
Prefix:
First Name:GIL
Middle Name:A
Last Name:NIEVES ALVAREZ
Suffix:II
Gender:M
Credentials:
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 850
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-0850
Mailing Address - Country:US
Mailing Address - Phone:787-403-0508
Mailing Address - Fax:787-863-1422
Practice Address - Street 1:AVE GENERAL VALERO # 305
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3949
Practice Address - Country:US
Practice Address - Phone:787-403-0508
Practice Address - Fax:787-863-1422
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR005456OtherSTATE LICENSE