Provider Demographics
NPI:1386377893
Name:NIEVES BORGES, JULIANA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:NIEVES BORGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TOWN CENTER DR APT 7112
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:GA
Mailing Address - Zip Code:31405-9570
Mailing Address - Country:US
Mailing Address - Phone:787-239-7897
Mailing Address - Fax:
Practice Address - Street 1:4717 US HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-2943
Practice Address - Country:US
Practice Address - Phone:912-898-0375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-03
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GARPH034660183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program