Individual
DR. JESSE A. PORTUGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3825 EDWARDS RD, SUITE 300, CINCINNATI, OH 45209-1287
(513) 221-1100
(513) 569-5297
Mailing address
PO BOX 643398, CINCINNATI, OH 45264-3398
(513) 221-1100
(513) 569-5297
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35.059435
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2142729
—
OH
Enumeration date
07/07/2006
Last updated
03/09/2016
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