Provider Demographics
NPI:1588168850
Name:NIEVES DIAZ, HENRY XAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:XAVIER
Last Name:NIEVES DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:V3 CALLE HIGUERO
Mailing Address - Street 2:QUINTAS DE VILLAMAR
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-478-4377
Mailing Address - Fax:
Practice Address - Street 1:MANATI MEDICAL CENTER
Practice Address - Street 2:URB. ATENAS, CALLE HERNANDEZ CARRION
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21671207QA0401X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice