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General NPI Number Information
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NPI Number | 1366918799
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Entity Type | Individual
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Provider Name | ZULEIMA NIEVES DE JESUS
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Gender | Female
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 99 CALLE GUILLERMO RIEFKKOHL SALIDA A PATILLAS
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City | PATILLAS
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State | PR
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Zip | 00723-0000
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Country | US
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Telephone | 787-839-4320
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Fax | 787-271-0004
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Provider Business Mailing Address
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Address Line | 99 CALLE GUILLERMO RIEFKKOHL SALIDAS A PATILLAS
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City | PATILLAS
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State | PR
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Zip | 00723
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Country | US
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Telephone | 787-839-4320
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Fax | 787-271-0004
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | 004801
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License Number State | PR
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