Provider Demographics
NPI:1386719276
Name:NIEVES, ZOILO LOPEZ (MD)
Entity type:Individual
Prefix:DR
First Name:ZOILO
Middle Name:LOPEZ
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 1682
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-1682
Mailing Address - Country:US
Mailing Address - Phone:787-768-3373
Mailing Address - Fax:787-768-3373
Practice Address - Street 1:AVE. CAMPO RICO - 7 / CORNER , SABANA GARDEN
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00983
Practice Address - Country:UM
Practice Address - Phone:787-768-3373
Practice Address - Fax:787-768-3373
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5600207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR065514OtherCRUZ AZUL
PR500050EOtherMEDICARE Y MUCHO MAS
PR27033OtherTRIPLE S
PR500050EOtherMEDICARE Y MUCHO MAS
PR27033OtherTRIPLE S
PR065514OtherCRUZ AZUL