Provider Demographics
NPI:1720721285
Name:NIEVES, MARIA TERESA (PMHNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:NIEVES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 CRACKER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5644
Mailing Address - Country:US
Mailing Address - Phone:787-505-2359
Mailing Address - Fax:
Practice Address - Street 1:1610 CRACKER CREEK CT
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5644
Practice Address - Country:US
Practice Address - Phone:787-505-2359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9392815163W00000X
FL11019263363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse