Doctor Name: | DR. JESSICA N. PORTELA |
NPI Number: | 1447404769 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 17,389 |
Business Practice Address: | 12 Villa Haydee Aguadilla, PR - 006035591 |
Business Phone Number: | 7875608268 |
Business Fax Number: | |
Mailing Address: | 12 Villa Haydee, AGUADILLA |
State: | PR |
Postal Code: | 006035591 |
Phone Number: | 7875608268 |
Fax Number: | |
NPI Enumeration Date: | 11/13/2008 |
NPI Last Update Date: | 02/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17,389 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |