Healthcare Provider Details

I. General information

NPI: 1952375107
Provider Name (Legal Business Name): KEYLA DEBORAH PRATTS RODRIGUEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/30/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 368 KM. 1.0 BO. MACHUCHAL
SABANA GRANDE PR
00637
US

IV. Provider business mailing address

PO BOX 61
HORMIGUEROS PR
00660
US

V. Phone/Fax

Practice location:
  • Phone: 787-652-2350
  • Fax:
Mailing address:
  • Phone: 787-317-1932
  • Fax: 787-264-3993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number13440
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: