Organization
SOUTH FLORIDA CRITICAL CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS PORTILLO M.D. (PRESIDENT)
(305) 281-9398
Entity
Organization
Contact information
Practice address
8370 W FLAGLER ST STE 226, MIAMI, FL 33144-2040
(305) 928-7249
(305) 630-3632
Mailing address
PO BOX 282070, TAMPA, FL 33630-2070
(305) 928-7249
(305) 630-3632
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024311500
—
FL
Enumeration date
01/22/2018
Last updated
06/26/2024
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