Provider Demographics
NPI:1992895049
Name:NIEVES MENDEZ, ADNEY D (MD)
Entity type:Individual
Prefix:MR
First Name:ADNEY
Middle Name:D
Last Name:NIEVES MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ADNEY
Other - Middle Name:D
Other - Last Name:NIEVES MENDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:960 URB. BRISAS DEL MONTE CALLE RUISENOR
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00617
Mailing Address - Country:UM
Mailing Address - Phone:787-650-8646
Mailing Address - Fax:787-650-8646
Practice Address - Street 1:CARR. 639 KM4.8
Practice Address - Street 2:BO. SABANA HOYOS
Practice Address - City:SABANA HOYOS
Practice Address - State:PR
Practice Address - Zip Code:00688
Practice Address - Country:US
Practice Address - Phone:787-650-8646
Practice Address - Fax:787-650-8646
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPR14234261Q00000X
PR14234208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center