Individual
KEYSHA MARIE LOPEZ VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
155 AVE ARTERIAL HOSTOS APT 222, SAN JUAN, PR 00918-2938
(787) 316-3753
Mailing address
1033 CALLE CERRO SALIENTE, URB. QUINTAS DE ALTAMIRA, JUANA DIAZ, PR 00795-9107
(787) 316-3753
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21131
PR
207RN0300X
Nephrology Physician
Primary
21131
PR
390200000X
Student in an Organized Health Care Education/Training Program
TL.0008177
CO
Other
Enumeration date
04/16/2015
Last updated
07/06/2021
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