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Organization
PORTILLA MEDICAL GROUP LLC
Active
Organization
PORTILLA MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIANELA DE LA PORTILLA M.D, (PRESIDENT/MEDICAL DIRECTOR)
(305) 631-1220
Entity
Organization
Contact information
Practice address
330 SW 27TH AVE, STE 302, MIAMI, FL 33135-2961
(305) 631-1220
(305) 631-1251
Mailing address
330 SW 27TH AVE, STE 302, MIAMI, FL 33135-2961
(305) 631-1220
(305) 631-1251
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/18/2013
Last updated
09/11/2014
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