Individual
DR. CARLOS PERDIGON PORTIELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEDIATRIC HPHYSICIAN
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-1111
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-1111
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
208000000X
Pediatrics Physician
Primary
HSE41403
FL
2471S1302X
Sonography Radiologic Technologist
P10710
—
Other
Enumeration date
09/18/2024
Last updated
05/16/2025
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