Healthcare Provider Details

I. General information

NPI: 1992895049
Provider Name (Legal Business Name): ADNEY D NIEVES MENDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ADNEY D NIEVES MENDEZ M.D.

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 639 KM4.8 BO. SABANA HOYOS
SABANA HOYOS PR
00688
US

IV. Provider business mailing address

960 URB. BRISAS DEL MONTE CALLE RUISENOR
BARCELONETA PUERTO RICO
00617
UM

V. Phone/Fax

Practice location:
  • Phone: 787-650-8646
  • Fax: 787-650-8646
Mailing address:
  • Phone: 787-650-8646
  • Fax: 787-650-8646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberPR14234
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number14234
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: