Healthcare Provider Details

I. General information

NPI: 1912858853
Provider Name (Legal Business Name): ISABEL CRISTINA PORTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 BIRD RD STE 403
CORAL GABLES FL
33146-1515
US

IV. Provider business mailing address

3850 BIRD RD STE 403
CORAL GABLES FL
33146-1515
US

V. Phone/Fax

Practice location:
  • Phone: 954-246-0789
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH28864
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: