| Doctor Name: | MR. NELSON JOSE ALDIVA |
| NPI Number: | 1700839297 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 16149 |
| Business Practice Address: | Hc 5 Box 25903 Bo. Puente Zarza Carr # 2 Km.90 Calle Interior Camuy, PR - 006279847 |
| Business Phone Number: | 7878205592 |
| Business Fax Number: | 7878205592 |
| Mailing Address: | Hc 5 Box 25903, Abra Honda Carr 4488 Km 1.0 CAMUY |
| State: | PR |
| Postal Code: | 006279847 |
| Phone Number: | 7878985573 |
| Fax Number: | 7878205592 |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 07/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 16149 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |