1225060049 NPI number — DR. MIGDALIA NIEVES CABAN M.D.

Table of content: DR. MIGDALIA NIEVES CABAN M.D. (NPI 1225060049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225060049 NPI number — DR. MIGDALIA NIEVES CABAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIEVES CABAN
Provider First Name:
MIGDALIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NIEVES
Provider Other First Name:
MIGDALIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1225060049
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 PASEO REAL MONTEJO
Provider Second Line Business Mailing Address:
HACIENDAS HERMANAS MENA
Provider Business Mailing Address City Name:
MANATI
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00674-5710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-884-0427
Provider Business Mailing Address Fax Number:
787-854-7141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
J18 CALLE ELLIOT VELEZ
Provider Second Line Business Practice Location Address:
URB. ATENAS
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-4616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-6474
Provider Business Practice Location Address Fax Number:
787-854-7141
Provider Enumeration Date:
07/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  7189 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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