Provider Demographics
NPI:1639925829
Name:NIEVES VAZQUEZ, LUIS R SR (FNP)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:R
Last Name:NIEVES VAZQUEZ
Suffix:SR
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 13839
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9805
Mailing Address - Country:US
Mailing Address - Phone:787-637-0554
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 13839
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-9805
Practice Address - Country:US
Practice Address - Phone:787-637-0554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program