Gonzales-Portillo, Gabriel Antonio

Gonzales-Portillo, Gabriel Antonio is an individual health care provider with primary practice located at 6919 N Dale Mabry Hwy Ste 100 , Tampa FL 33614-3972. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Gonzales-Portillo, Gabriel Antonio can be contacted via phone (813) 467-4290.

Contact Information

Primary practice address
6919 N Dale Mabry Hwy Ste 100 Tampa FL 33614-3972
Phone: (813) 467-4290
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X ME93271 Florida

Profile Details

NPI number 1811992357
LBN Legal business name Gonzales-Portillo, Gabriel Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Jul 28th, 2023 - about 3 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 1811992357 NPPES
Florida MEDICAID 272860500

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