Provider Demographics
NPI:1356973374
Name:NIEVES CORDERO, SILVIA E (RPT)
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:E
Last Name:NIEVES CORDERO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. GOLDEN HILLS
Mailing Address - Street 2:1539 AVE LOS ASTROS
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-6943
Mailing Address - Country:US
Mailing Address - Phone:939-235-4300
Mailing Address - Fax:
Practice Address - Street 1:URB SANTA JUANITA
Practice Address - Street 2:UU-43, CALLE 30
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4701
Practice Address - Country:US
Practice Address - Phone:787-787-8669
Practice Address - Fax:787-786-7865
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004526225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist