Individual
DR. DAMIAN PORTELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3347 STATE ROAD 7, SUITE 101, WELLINGTON, FL 33449-8095
(561) 790-2111
(561) 296-0436
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME94172
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1062405
CAREPLUS
FL
01
—
11147
DIMENSION HEALTH
FL
01
—
1242202
WELLCARE
FL
01
—
32647
BCBS
FL
01
—
7451633
AETNA
FL
01
—
P01250
FREEDOM
FL
01
—
P01596411
RR MEDICARE
FL
01
—
P929225
OPTIMUM
FL
Enumeration date
01/06/2006
Last updated
10/13/2016
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