Provider Demographics
NPI:1548524374
Name:NORIEGA, NILSA E
Entity type:Individual
Prefix:MS
First Name:NILSA
Middle Name:E
Last Name:NORIEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 NW 14TH ST FL 12
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-2107
Mailing Address - Country:US
Mailing Address - Phone:347-691-5523
Mailing Address - Fax:305-243-3501
Practice Address - Street 1:1120 NW 14TH ST FL 12
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2107
Practice Address - Country:US
Practice Address - Phone:347-691-5523
Practice Address - Fax:305-243-3501
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator