Portnova, Regina B

Portnova, Regina B is an sole proprietor health care provider with primary practice located at 2951 Nw 49Th Ave Suite 201, Lauderdale Lakes FL 33313-1608. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Portnova, Regina B can be contacted via phone (945) 486-5700.

Contact Information

Primary practice address
2951 Nw 49Th Ave Suite 201 Lauderdale Lakes FL 33313-1608
Phone: (945) 486-5700
Fax: (954) 484-2574
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME91789 Florida

Profile Details

NPI number 1114908373
LBN Legal business name Portnova, Regina B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2005
Last updated May 6th, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114908373 NPPES
Florida MEDICAID 271339000

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