GUSTAVO DE LA PORTILLA MD PA (NPI# 1376797027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376797027 |
| Entity Type | Organization |
| Organization Name | GUSTAVO DE LA PORTILLA MD PA |
| Practice Address |
11452 Quail Roost Dr Miami FL 33157-6546 |
| Practice Telephone | 3052551966 |
| Practice Fax Number | 3052590147 |
| Mailing Telephone | 3052551966 |
| Mailing Fax Number | 3052590147 |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2016-04-28 |
| Authorized Official Name | GUSTAVO DE LA PORTILLA (PRESIDENT) |
| Authorized Official Telephone | 3052551966 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ME83614 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
11452 QUAIL ROOST DR |
| City | MIAMI |
| State | FL |
| Zip Code | 33157-6546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457331720 | Hector Garcia | Podiatrist | 11452 Quail Roost Dr, Miami, FL 33157-6546 | 2006-01-20 |
| 1538211685 | Hector Garcia Dpm Pa | Podiatrist | 11452 Quail Roost Dr, Miami, FL 33157-6546 | 2007-01-17 |
| 1932118254 | Gustavo A De La Portilla | General Practice | 11452 Quail Roost Dr, Miami, FL 33157-6546 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831711399 | Palmetto Bay Retirement Home | Assisted Living Facility | 9220 Sw 174th Street, Palmetto Bay, FL 33157 | 2020-05-07 |
| 1033752886 | Jean Carlos Alf, Inc. | Assisted Living Facility | 9760 Memorial Road, Cutler Bay, FL 33157 | 2019-10-24 |
| 1912470238 | Metro Transport Services LLC | Non-emergency Medical Transport (VAN) | 18495 South Dixie Highway #233, Miami, FL 33157 | 2019-01-09 |
| 1871079921 | Paul Amailuk | Dentist | 9333 Sw 152nd Street, Oral and Maxillofacial Surgery Department, Miami, FL 33157 | 2018-07-12 |
| 1891283297 | Arianna Michelle Endara | Occupational Therapist | 10920 Sw 186th Street, Miami, FL 33157 | 2018-05-01 |
| 1841798022 | Yanet Rodriguez | Behavioral Analyst | 10920 Sw 200th Dr #100, Cutler Bay, FL 33157 | 2018-01-23 |
| 1548777543 | Ceda Orthopedics & Interventional Medicine | Chiropractor | 10974 Sw 184th Street, Miami, FL 33157 | 2017-12-29 |
| 1033635438 | Gabriela Deschamps | Behavior Technician | 15385 S Dixie Hwy, Apt 4, Miami, FL 33157 | 2017-08-17 |
| 1811411598 | Rebeca Molina De Tamayo | Behavior Technician | 9507 Sw 160th Street, Suite 250, Miami, FL 33157 | 2017-08-03 |
| 1194249912 | Family Love Behavioral Health Care LLC | Behavioral Analyst | 18901 Sw 106 Avenue, Suite A-227, Miami, FL 33157 | 2017-08-02 |
| Find all providers in zip 33157 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
| 1942815774 | Mocasa Wellness Center Inc | General Practice | 330 Sw 27th Ave Ste 506, Miami, FL 33135-2967 | 2020-09-09 |
| 1316550163 | Asela Infante Suarez | General Practice | 13450 Sw 97th Ct, Miami, FL 33176-6105 | 2020-08-30 |
| 1740890607 | Serenity Community Mental Healthcare, LLC | General Practice | 10300 Sw 72nd St Ste 250, Miami, FL 33173-3014 | 2020-08-05 |
| 1144841776 | Simplify Home Health Pllc | General Practice | 3301 Ne 1st Ave Apt 2906, Miami, FL 33137-4174 | 2020-05-05 |
| 1104447804 | Dr Jean Pierre LLC | General Practice | 5050 Biscayne Blvd, Miami, FL 33137-3203 | 2020-05-04 |
| 1891316105 | Jorge Luis Vega Morales | General Practice | 14760 Sw 66th St, Miami, FL 33193-2039 | 2020-04-28 |
| 1518587203 | Premium Healthcare Holdings, Lllp | General Practice | 2400 Sw 69th Ave, Miami, FL 33155-1706 | 2020-04-22 |
| 1770118416 | Guido A.perez, M.d., Inc. | General Practice | 701 Nw 57th Ave Ste 260, Miami, FL 33126-2083 | 2020-03-03 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.