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General NPI Number Information
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NPI Number | 1609481449
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Entity Type | Organization
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Legal Business Name | IPA POLICLINICA FAMILIAR FACTOR DOCTORES NIEVES, CSP
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | CARR 2 KM 65.6 BO FACTOR 1
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City | ARECIBO
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State | PR
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Zip | 00612
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Country | US
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Telephone | 787-815-6536
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 970
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City | ARECIBO
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State | PR
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Zip | 00613-0970
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Country | US
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Telephone | 787-815-6536
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE LUIS NIEVES
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Credential | MD
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Telephone | 787-815-6536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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