Individual
JONATHAN PORTUONDO-SUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 S 4TH ST, LOUISVILLE, KY 40203-3205
(502) 819-1132
Mailing address
4180 LYNDON WAY UNIT 409, LOUISVILLE, KY 40207-5042
(502) 819-1132
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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