Provider Demographics
NPI:1306072848
Name:NIEVES, MONICA (MT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:NIEVES
Suffix:
Gender:F
Credentials:MT
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 737
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0737
Mailing Address - Country:US
Mailing Address - Phone:787-590-7961
Mailing Address - Fax:787-830-0465
Practice Address - Street 1:AVE NOEL ESTRADA
Practice Address - Street 2:APT 737
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-830-2747
Practice Address - Fax:787-830-0465
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6953247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician