Portogues, Carmen G

Portogues, Carmen G is an individual health care provider with primary practice located at 1901 S.W. 172 Ave. Memorial Hospital Miramar, Miramar FL 33029. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Portogues, Carmen G can be contacted via phone (954) 538-5000.

Contact Information

Primary practice address
1901 S.W. 172 Ave. Memorial Hospital Miramar Miramar FL 33029
Phone: (954) 538-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2405 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA 2405 Florida

Profile Details

NPI number 1023091717
LBN Legal business name Portogues, Carmen G
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2005
Last updated Dec 31st, 2013 - about 13 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 1023091717 NPPES
Florida MEDICAID 293012900
Florida Other E1344U

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