| Luis R. Nieves Gonzalez Md, Psc | |
|
Carretera 2 Km 112.2 Bo Mora Isabela PR 00662-0000 | |
| (787) 830-8866 | |
| (787) 830-8866 |
| Full Name | Luis R. Nieves Gonzalez Md, Psc |
|---|---|
| Speciality | General Practice |
| Location | Carretera 2 Km 112.2, Isabela, Puerto Rico |
| Authorized Official Name and Position | Luis Rafael Nieves Gonzalez (PRESIDENT) |
| Authorized Official Contact | 7878308866 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luis R. Nieves Gonzalez Md, Psc Po Box 484 Isabela PR 00662-0484 Ph: (787) 830-8866 | Luis R. Nieves Gonzalez Md, Psc Carretera 2 Km 112.2 Bo Mora Isabela PR 00662-0000 Ph: (787) 830-8866 |
| NPI Number | 1760787071 |
|---|---|
| Provider Enumeration Date | 01/18/2011 |
| Last Update Date | 01/21/2011 |
| Medicare PECOS PAC ID | 7618156795 |
|---|---|
| Medicare Enrollment ID | O20110120001123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760787071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Luis R Nieves Gonzalez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215976782 PECOS PAC ID: 3375553704 Enrollment ID: I20060501000392 |
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