Provider Demographics
NPI:1043625007
Name:NIEVES TIRADO, MARIA LUISA (MD, FAAP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LUISA
Last Name:NIEVES TIRADO
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-0515
Mailing Address - Country:US
Mailing Address - Phone:787-869-5900
Mailing Address - Fax:787-869-6120
Practice Address - Street 1:CARR 152 KM 12.2
Practice Address - Street 2:BARRIO PEDRO ARRIBA
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-1290
Practice Address - Fax:787-867-5210
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR19685208000000X
PR31449-R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics