MEDICARE: HIRAM ORTEGA NIEVES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	8159	PR
2	208D00000X	General Practice Physician	8159	PR
3	171100000X	Acupuncturist	8159	PR

General Provider Information

NPI Number	:	1033110275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIRAM ORTEGA NIEVES MD

Provider Business Mailing Address
First Line	:	PO BOX 998
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602-0998
Country	:	US
Telephone Number	:	787-868-5455
Fax Number	:	787-868-5455

Provider Business Practice Location Address
First Line	:	93 CALLE COLON
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602-3115
Country	:	US
Telephone Number	:	787-868-5455
Fax Number	:	787-868-5455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	12/07/2010

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