Provider Demographics
NPI:1851702674
Name:NIEVES, JONATHAN PHILLIP (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PHILLIP
Last Name:NIEVES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1608 SE 3RD AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2564
Mailing Address - Country:US
Mailing Address - Phone:954-785-0300
Mailing Address - Fax:954-785-0029
Practice Address - Street 1:1 W SAMPLE RD STE 204
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3547
Practice Address - Country:US
Practice Address - Phone:954-785-0300
Practice Address - Fax:954-785-0229
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2025-01-27
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Provider Licenses
StateLicense IDTaxonomies
FLME135343207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology