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General NPI Number Information
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NPI Number | 1518653476
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Entity Type | Individual
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Provider Name | ANDREA LIZ ASTOR NIEVES
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Gender | Female
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 551 AVE. ESCORIAL URB. CAPARRA HEIGHTS
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-782-0403
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Fax |
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Provider Business Mailing Address
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Address Line | URB. LOS ARBOLES DE MONTEHIEDRA 393 BLVD. DE LOS ARBOLES
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-782-0403
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3544
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License Number State | PR
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