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: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 ZONA IND REPARADA 2 CALLE DR LUIS F SALAS
PONCE PR
00716-7004
US

IV. Provider business mailing address

PO BOX 7004
PONCE PR
00732-7004
US

V. Phone/Fax

Practice location:
  • Phone: 787-812-2525
  • Fax:
Mailing address:
  • Phone: 787-812-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24309
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: