Provider Demographics
NPI:1902081110
Name:NIEVES, HIRAM SR
Entity Type:Individual
Prefix:MR
First Name:HIRAM
Middle Name:
Last Name:NIEVES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 HIBISCUS ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOHN
Mailing Address - State:FL
Mailing Address - Zip Code:32927-8737
Mailing Address - Country:US
Mailing Address - Phone:321-202-9347
Mailing Address - Fax:
Practice Address - Street 1:1011 HIBISCUS ST
Practice Address - Street 2:
Practice Address - City:PORT ST JOHN
Practice Address - State:FL
Practice Address - Zip Code:32927-8737
Practice Address - Country:US
Practice Address - Phone:321-202-9347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion