SearchFlorida101YM0800X

Manuel De La Portilla, MH6485

NPI 1831357474 · on the registry since 2008

Practice

Address
15660 Sw 72nd St
Miami, FL 33193
Phone
(786) 697-1150
Fax
(786) 541-1526
Organisation at this address
The Gymnastics Academy, Co.
Miracle Community Behavioral Center Corp
Inferred from a shared address, not stated in the registry.
Clinicians at this address
3

Additional practice sites

  • 7800 Sw 57th Ave, South Miami, FL

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-11-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida