Provider Demographics
NPI:1881816395
Name:FELICIANO NIEVES, SONIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:FELICIANO NIEVES
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:SALUS STREET # 1326
Mailing Address - Street 2:EL SENORIAL COND PH 1009
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-613-6969
Mailing Address - Fax:787-842-0634
Practice Address - Street 1:SALUS STREET # 1326
Practice Address - Street 2:EL SENORIAL COND PH 1009
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-613-6969
Practice Address - Fax:787-842-0634
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR3971208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC79371Medicare UPIN