Provider Demographics
NPI:1831218619
Name:RESTO TORRES, KEILA S (MD)
Entity type:Individual
Prefix:DR
First Name:KEILA
Middle Name:S
Last Name:RESTO TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 AVE PEDRO ALBIZU CAMPO APT 20
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-5470
Mailing Address - Country:US
Mailing Address - Phone:939-639-3565
Mailing Address - Fax:
Practice Address - Street 1:ROAD 108, KM 4.5, REPARTO LA RUEDA #9
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:939-639-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16,629208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice