Provider Demographics
NPI:1588929624
Name:NIEVES-RIVERA, JUAN JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:JOSE
Last Name:NIEVES-RIVERA
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 2617
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-2617
Mailing Address - Country:US
Mailing Address - Phone:787-898-8777
Mailing Address - Fax:787-933-8497
Practice Address - Street 1:PR-130 KM. 11.8
Practice Address - Street 2:BO. CAMPO ALEGRE
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-898-8777
Practice Address - Fax:787-933-8497
Is Sole Proprietor?:No
Enumeration Date:2012-07-04
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18756207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine