Provider Demographics
NPI:1285937961
Name:NIEVES, MIGUEL ANGEL FIGUEROA SR (RPH)
Entity type:Individual
Prefix:MR
First Name:MIGUEL ANGEL
Middle Name:FIGUEROA
Last Name:NIEVES
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:491 CALLE GUAMA
Mailing Address - Street 2:FAJARDO GARDENS
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-3068
Mailing Address - Country:US
Mailing Address - Phone:787-502-4018
Mailing Address - Fax:787-863-2070
Practice Address - Street 1:CALLE UNION 1
Practice Address - Street 2:SANTA ISIDRA
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3068
Practice Address - Country:US
Practice Address - Phone:787-863-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2191OtherSTATE LICENSE