Provider Demographics
NPI:1053918656
Name:TORO VEGA, KEILEEN E (MD)
Entity type:Individual
Prefix:DR
First Name:KEILEEN
Middle Name:E
Last Name:TORO VEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KEILEEN
Other - Middle Name:EHNAR
Other - Last Name:TORO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:URBANIZACION EL VERDE, CALLE SATURNO, CASA #74
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-930-0605
Mailing Address - Fax:
Practice Address - Street 1:DEL RIO SHOPPING LOCAL A2-1 URB. VALLE TOLIMA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-653-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22034208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice