Provider Demographics
NPI:1750267183
Name:GONZALEZ NIEVES, YANIRA
Entity type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:GONZALEZ NIEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB MONTE MAYOR
Mailing Address - Street 2:CALLE FLAMENCO 597
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:939-397-7199
Mailing Address - Fax:
Practice Address - Street 1:CENTRO DE DIAGNOSTICO PARA INTELIGENCIAS MULTIPLES
Practice Address - Street 2:CALLE VICTORIA 1551
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-722-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR655225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist