Provider Demographics
NPI:1033513676
Name:NIEVES, NORMA I (RPH)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:I
Last Name:NIEVES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3556 SE MONTGOMERY CIR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-3131
Mailing Address - Country:US
Mailing Address - Phone:863-231-2090
Mailing Address - Fax:863-993-0517
Practice Address - Street 1:3556 SE MONTGOMERY CIR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-3131
Practice Address - Country:US
Practice Address - Phone:863-231-2090
Practice Address - Fax:863-993-0517
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS25941183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy