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General NPI Number Information
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NPI Number | 1306708292
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Entity Type | Individual
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Provider Name | ANGEL DANIEL NIEVES ALICEA
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Gender | Male
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Dates
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Enumeration Date | 11/29/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 10 CALLE CASIA
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City | SAN JUAN
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State | PR
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Zip | 00921-3200
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Country | US
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Telephone | 787-641-7582
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Fax |
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Provider Business Mailing Address
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Address Line | HC 3 BOX 7410
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City | COMERIO
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State | PR
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Zip | 00782-9583
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 6804214
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 6804214
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License Number State | PR
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