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General NPI Number Information
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NPI Number | 1356725592
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Entity Type | Individual
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Provider Name | ERICA NICOLE NIEVES O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 09/30/2015
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Provider Practice Location Address
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Address Line | 550 US HIGHWAY 27
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City | CLERMONT
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State | FL
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Zip | 34714
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Country | US
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Telephone | 407-666-0828
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Fax | 866-838-6099
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Provider Business Mailing Address
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Address Line | 1142 WILDE DR
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City | CELEBRATION
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State | FL
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Zip | 34747-4046
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Country | US
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Telephone | 407-922-5870
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC5087
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License Number State | FL
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