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Individual

JESSICA PORTILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BD1200X
Dialysis Equipment & Supplies (DME)
332BN1400X
Nursing Facility Supplies (DME)
332BX2000X
Oxygen Equipment & Supplies (DME)
335E00000X
Prosthetic/Orthotic Supplier

Other

Enumeration date
11/08/2016
Last updated
11/08/2016
Update your record

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