MEDICARE: JAVIER A TORRES-NIEVES 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	208D00000X	General Practice Physician	15687	PR
2	207R00000X	Internal Medicine Physician	15687	PR

General Provider Information

NPI Number	:	1528128832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAVIER A TORRES-NIEVES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1177
Second Line	:
City	:	GURABO
State	:	PR
Zip	:	00778-1177
Country	:	US
Telephone Number	:	787-852-0768
Fax Number	:	787-687-7691

Provider Business Practice Location Address
First Line	:	355 CALLE FONT MARTELO
Second Line	:
City	:	HUMACAO
State	:	PR
Zip	:	00791-3249
Country	:	US
Telephone Number	:	787-366-2969
Fax Number	:	787-687-7691

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	02/12/2023

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