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General NPI Number Information
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NPI Number | 1265162382
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Entity Type | Individual
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Provider Name | ALEJANDRO ANDRES NIEVES MONTALVO DMD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 1012 US-98 UNIT 1
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City | DESTIN
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State | FL
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Zip | 32541
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Country | US
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Telephone | 786-451-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 2638 NW 104TH AVE APT 106
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City | SUNRISE
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State | FL
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Zip | 33322-6305
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Country | US
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Telephone | 786-451-0701
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 26942
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License Number State | FL
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