Individual
ELYSE NICOLE PORTILLO
Active
Individual
ELYSE NICOLE PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
S8098
TX
208000000X
Pediatrics Physician
265871
MA
Other
Enumeration date
04/01/2013
Last updated
08/24/2020
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