Individual
DR. TINA M. PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14000 FAIRVIEW DR, BURNSVILLE, MN 55337-5713
(952) 993-8700
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54226
MN
Other
Enumeration date
07/01/2010
Last updated
03/11/2021
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