MEDICARE: GIL ANGEL 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	207Q00000X	Family Medicine Physician	6845	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010065743	OTHER	PR	PALMETTO
2	068567	OTHER	PR	CRUZ AZUL DE PUERTO RICO
3	200070	OTHER	PR	PREFERRED HEALTH
4	1156845	OTHER	PR	GLOBAL HEALTH PLAN
5	PE2171	OTHER	PR	PALIC PROVIDER
6	9360053	OTHER	PR	HUMANA INSURANCE
7	9360053	OTHER	PR	HUMANA HEALTH PLAN
8	01043	OTHER	PR	AMERICAN HEALTH
9	28578	OTHER	PR	TRIPLE S

General Provider Information

NPI Number	:	1841247772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIL ANGEL NIEVES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2017
Second Line	:	PMB 425
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00771-2017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 CALLE BARBOSA
Second Line	:
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00771-3957
Country	:	US
Telephone Number	:	787-733-2444
Fax Number	:

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	10/11/2012

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