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Individual

FERNANDO GONZALES-PORTILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6735 CONROY RD, SUITE 229, ORLANDO, FL 32835
(407) 581-8640
(407) 581-8659
Mailing address
6735 CONROY RD, SUITE 229, ORLANDO, FL 32835
(407) 581-8640
(407) 581-8659

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
29251
AZ
2084N0400X
Neurology Physician
Primary
ME95934
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276495400
FL
Enumeration date
02/17/2006
Last updated
01/29/2020
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