Individual
IDA ORLANDA PORTELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6319 NW 173RD TER, HIALEAH, FL 33015-4487
(786) 486-6818
Mailing address
18260 MEDITERRANEAN BLVD APT 907, HIALEAH, FL 33015-5700
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
20-117845
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/20/2020
Last updated
06/03/2022
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