Provider Demographics
NPI:1851702674
Name:NIEVES, JONATHAN PHILLIP (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PHILLIP
Last Name:NIEVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2825 N STATE ROAD 7 STE 205
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5737
Mailing Address - Country:US
Mailing Address - Phone:954-719-0717
Mailing Address - Fax:954-727-5195
Practice Address - Street 1:2825 N STATE ROAD 7 STE 205
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5737
Practice Address - Country:US
Practice Address - Phone:954-719-0717
Practice Address - Fax:954-727-5195
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME135343207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology