Individual
ERIC PORTALATIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6 E BAY ST STE 101, JACKSONVILLE, FL 32202-5416
(904) 356-0072
Mailing address
8283 BAYMEADOWS RD E APT 1218, JACKSONVILLE, FL 32256-3058
(904) 874-3534
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN27107
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/09/2022
Last updated
04/21/2026
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