Doctor Name: | OSVALDO NIEBLA DIAZ |
NPI Number: | 1174550131 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 15476 |
Business Practice Address: | 112 Acuarela. Quintavalle Apto. 118 Guaynabo, PR - 009693599 |
Business Phone Number: | 7877081712 |
Business Fax Number: | |
Mailing Address: | 112 Acuarela. Quintavalle, Apto. 118 GUAYNABO |
State: | PR |
Postal Code: | 009693599 |
Phone Number: | 7877081712 |
Fax Number: | |
NPI Enumeration Date: | 06/27/2006 |
NPI Last Update Date: | 01/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 15476 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |