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General NPI Number Information
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NPI Number | 1225014061
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Entity Type | Individual
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Provider Name | PEDRO LUIS NIEVES GARNICA I M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 334 OFICINA 1 AVE. AMERICO MIRANDA URB VILLA NEVAREZ
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City | SAN JUAN
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State | PR
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Zip | 00927-4721
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Country | US
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Telephone | 787-767-4853
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Fax | 787-767-4853
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Provider Business Mailing Address
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Address Line | DELCASSE 20, APT. 1103
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City | SAN JUAN
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State | PR
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Zip | 00907-1698
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Country | US
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Telephone | 787-767-4853
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Fax | 787-767-4853
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 8116
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License Number State | PR
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