Healthcare Provider Details

I. General information

NPI: 1245857770
Provider Name (Legal Business Name): KEISY MARIE ALVAREZ ACEVEDO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR- 349 KM 2.7 CERRO LAS MESAS
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

PO BOX 1750
MAYAGUEZ PR
00681-1750
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-6000
  • Fax:
Mailing address:
  • Phone: 787-834-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number24309
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: