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Individual

DR. RAUL PORTELA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1475 W 49TH ST, HIALEAH, FL 33012-3222
(305) 558-2500
(305) 826-9002
Mailing address
1475 W 49TH ST, HIALEAH, FL 33012-3222
(305) 558-2500
(305) 826-9002

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
ME0059713
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12502
BLUE CROSS OF FLORIDA
FL
Enumeration date
01/15/2007
Last updated
07/09/2007
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