Provider Demographics
NPI:1891773206
Name:NIEVES, GIOVANNY I
Entity Type:Individual
Prefix:
First Name:GIOVANNY
Middle Name:I
Last Name:NIEVES
Suffix:
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 1:3243 ALLANDALE DR
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-3376
Mailing Address - Country:US
Mailing Address - Phone:727-642-5008
Mailing Address - Fax:
Practice Address - Street 1:15100 RESCUE WAY
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-3524
Practice Address - Country:US
Practice Address - Phone:727-535-1437
Practice Address - Fax:727-535-4190
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician