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Individual
DR. WANDA IVELISSE NIEVES-MORENO
Active
Individual
DR. WANDA IVELISSE NIEVES-MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH8811
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381946900
—
FL
01
—
U6011Z
MEDICARE PTAN
FL
Enumeration date
09/14/2005
Last updated
08/04/2026
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