Provider Demographics
NPI:1952089070
Name:NIEVES, CECILIO ENRIQUE (RNA)
Entity Type:Individual
Prefix:MR
First Name:CECILIO
Middle Name:ENRIQUE
Last Name:NIEVES
Suffix:
Gender:M
Credentials:RNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:I7 CALLE OROCOBIX
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-3523
Mailing Address - Country:US
Mailing Address - Phone:787-455-0489
Mailing Address - Fax:
Practice Address - Street 1:I7 CALLE OROCOBIX
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3523
Practice Address - Country:US
Practice Address - Phone:787-455-0489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR625367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered