Individual
MR. JUAN PABLO PORTOCARRERO CACERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3901 RAINBOW BLVD # MS 3002, KANSAS CITY, KS 66160-2908
(913) 588-6048
Mailing address
3901 RAINBOW BLVD # MS 3002, KANSAS CITY, KS 66160-8500
(913) 588-6048
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125070123
IL
207RN0300X
Nephrology Physician
Primary
125070123
IL
Other
Enumeration date
03/26/2017
Last updated
07/11/2023
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