| Doctor Name: | BENNY NIEVES-MATIAS |
| NPI Number: | 1669874681 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 18893 |
| Business Practice Address: | Carr. 199, Km 1.2 Guaynabo, PR - 00969 |
| Business Phone Number: | 7877408787 |
| Business Fax Number: | |
| Mailing Address: | #1757 Lopez Landron St., Urb Stgo. Iglesias SAN JUAN |
| State: | PR |
| Postal Code: | 00921 |
| Phone Number: | 7872348235 |
| Fax Number: | |
| NPI Enumeration Date: | 09/22/2014 |
| NPI Last Update Date: | 09/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 18893 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |