Provider Demographics
NPI:1841247772
Name:NIEVES, GIL ANGEL (MD)
Entity type:Individual
Prefix:
First Name:GIL
Middle Name:ANGEL
Last Name:NIEVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2017
Mailing Address - Street 2:PMB 425
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-2017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:68 CALLE BARBOSA
Practice Address - Street 2:
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-3957
Practice Address - Country:US
Practice Address - Phone:787-733-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR010065743OtherPALMETTO
PR068567OtherCRUZ AZUL DE PUERTO RICO
PR200070OtherPREFERRED HEALTH
PR1156845OtherGLOBAL HEALTH PLAN
PRPE2171OtherPALIC PROVIDER
PR9360053OtherHUMANA INSURANCE
PR9360053OtherHUMANA HEALTH PLAN
PR01043OtherAMERICAN HEALTH
PR28578OtherTRIPLE S
PRD08464Medicare UPIN
PR010065743OtherPALMETTO