| Doctor Name: | JOSE L. PORTALATIN RODRIGUEZ |
| NPI Number: | 1780616656 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 14953 |
| Business Practice Address: | 1718 Woolco Way Orlando, FL - 328222854 |
| Business Phone Number: | 4076747886 |
| Business Fax Number: | 4076747887 |
| Mailing Address: | 931 W Oak St, Ste 103 KISSIMMEE |
| State: | FL |
| Postal Code: | 347414973 |
| Phone Number: | 4079310444 |
| Fax Number: | 4079624446 |
| NPI Enumeration Date: | 07/07/2006 |
| NPI Last Update Date: | 03/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 14953 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |