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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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 1205824299 NPPES
Florida MEDICAID 265847000

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