Provider Demographics
NPI:1821364779
Name:MARCHENA NIEVES, ORLANDO JAVIER JR (MD)
Entity type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:JAVIER
Last Name:MARCHENA NIEVES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 AVE TITO CASTRO
Mailing Address - Street 2:SUITE 102 PMB 353
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0200
Mailing Address - Country:US
Mailing Address - Phone:787-509-7744
Mailing Address - Fax:
Practice Address - Street 1:CALLE LA CRUZ # 3
Practice Address - Street 2:SUITE 1
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-837-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR018376208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice