Healthcare Provider Details

I. General information

NPI: 1528023942
Provider Name (Legal Business Name): EUGENIO A PORTELA ASENIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EUGENIO A PORTELA MD

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LUIS MUNOZ RIVERA 110 SUR
CAYEY PR
00736-9623
US

IV. Provider business mailing address

PO BOX 270347
SAN JUAN PR
00928-0347
US

V. Phone/Fax

Practice location:
  • Phone: 787-751-0330
  • Fax: 787-767-7786
Mailing address:
  • Phone: 787-751-0330
  • Fax: 787-767-7786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number4741
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number04741
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: