Organization
PORTELA E.N.T., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDICE GALVIN (SECRETARY)
(305) 669-7144
Entity
Organization
Contact information
Practice address
3100 SW 62ND AVE STE 124, MIAMI, FL 33155-3009
(305) 669-7144
(305) 663-8545
Mailing address
3100 SW 62ND AVE STE 124, MIAMI, FL 33155-3009
(305) 669-7144
(305) 663-8545
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME114535
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008496300
—
FL
Enumeration date
08/31/2017
Last updated
07/21/2022
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