Provider Demographics
NPI:1821016114
Name:DEL TORO, SALLY (MD, MPH)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:DEL TORO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 AVE JULIO E MONAGAS
Mailing Address - Street 2:CONSTANCIA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-2205
Mailing Address - Country:US
Mailing Address - Phone:787-843-9604
Mailing Address - Fax:
Practice Address - Street 1:3175 AVE JULIO E MONAGAS
Practice Address - Street 2:CONSTANCIA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2205
Practice Address - Country:US
Practice Address - Phone:787-843-9604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12293208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0023159Medicare ID - Type UnspecifiedPARTICIPATING PROVIDER