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NPI Code Detail

MEDICARE: DIANA MARIE NIEVES THL

MEDICARE: DIANA MARIE NIEVES THL
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
12355S0801XSpeech-Language Assistant007606PR

General Provider Information

NPI Number : 1538908512
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA MARIE NIEVES THL
Provider Business Mailing Address
First Line : 1748 BO TABLONAL
Second Line :
City : AGUADA
State : PR
Zip : 00602-2439
Country : US
Telephone Number : 939-323-3796
Fax Number :
Provider Business Practice Location Address
First Line : 66 CALLE MJ CABRERO
Second Line :
City : SAN SEBASTIAN
State : PR
Zip : 00685-4843
Country : US
Telephone Number : 787-955-0270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2024
Last Update Date : 05/21/2024

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Directions to “ DIANA MARIE NIEVES THL” Practice Location

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