Provider Demographics
NPI:1841262078
Name:GILROY TORRES, KELLY SUE (MD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:SUE
Last Name:GILROY 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 1:117 BO BAJURAS
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-820-7722
Mailing Address - Fax:787-820-7722
Practice Address - Street 1:AVE MUNOZ RIVERA 168
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00627
Practice Address - Country:UM
Practice Address - Phone:787-820-7722
Practice Address - Fax:787-820-7722
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14483208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
H80203Medicare UPIN
21202Medicare ID - Type Unspecified