Portillo, Douglas
Portillo, Douglas is an sole proprietor health care provider with primary practice located at 5000 University Dr , Coral Gables FL 33146-2008. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Portillo, Douglas can be contacted via phone (305) 928-7249.Contact Information
Primary practice address
5000 University Dr
Coral Gables FL 33146-2008
Phone: (305) 928-7249
Fax: (306) 630-3632
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | ME 84645 | Florida |
Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | ME84645 | Florida |
Profile Details
NPI number | 1205824299 |
---|---|
LBN Legal business name | Portillo, Douglas |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 12th, 2005 |
Last updated | Nov 29th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1205824299 | NPPES |
Florida | MEDICAID | 265847000 |
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