Provider Demographics
NPI:1780667196
Name:TORO, KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:TORO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 844
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0844
Mailing Address - Country:US
Mailing Address - Phone:787-851-3683
Mailing Address - Fax:787-851-3683
Practice Address - Street 1:29 CALLE PASARELL
Practice Address - Street 2:EDF. YAUCO MILLENIUM, OFICINA # 4
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3679
Practice Address - Country:US
Practice Address - Phone:787-856-0908
Practice Address - Fax:787-856-0908
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13950208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83954Medicaid
H81711Medicare UPIN
PR0083954Medicare ID - Type Unspecified