1255344859 NPI number — DR. LUIS FRANCISCO NIEVES GARRASTEGUI MD

Table of content: DR. LUIS FRANCISCO NIEVES GARRASTEGUI MD (NPI 1255344859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255344859 NPI number — DR. LUIS FRANCISCO NIEVES GARRASTEGUI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIEVES GARRASTEGUI
Provider First Name:
LUIS
Provider Middle Name:
FRANCISCO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255344859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MALAGUETA ST.
Provider Second Line Business Mailing Address:
310 LOS ARBOLES DE MONTEHIEDRA
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-767-6777
Provider Business Mailing Address Fax Number:
787-767-6878

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
369 AVE. DE DIEGO
Provider Second Line Business Practice Location Address:
308 TORRE SAN FRANCISCO
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-767-6777
Provider Business Practice Location Address Fax Number:
787-767-6878
Provider Enumeration Date:
08/14/2006

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: 207RP1001X , with the licence number:  10618 , 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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