MEDICARE: DR. ALEJANDRO A PORRATA NIEVA M.D.

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	208VP0014X	Interventional Pain Medicine Physician	15828	PR
2	208VP0014X	Interventional Pain Medicine Physician	ME87063	FL

General Provider Information

NPI Number	:	1033112529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEJANDRO A PORRATA NIEVA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 16698
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00908-6698
Country	:	US
Telephone Number	:	787-420-9259
Fax Number	:

Provider Business Practice Location Address
First Line	:	29 CALLE WASHINGTON
Second Line	:	STE. 303
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1510
Country	:	US
Telephone Number	:	787-721-2250
Fax Number	:

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	03/17/2020

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