Individual
EDRICK NIEVES GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
975 AVE HOSTOS, SUITE 62, MAYAGUEZ, PR 00680-1251
(787) 832-5540
(787) 832-5540
Mailing address
PO BOX 3294, MAYAGUEZ, PR 00681-3294
(787) 501-4333
(787) 805-0288
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
155525
FL
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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