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General NPI Number Information
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NPI Number | 1184119810
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Entity Type | Organization
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Legal Business Name | CARLOS PORTU MD PLLC
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 950 MANATEE RD
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City | NAPLES
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State | FL
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Zip | 34114-8219
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Country | US
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Telephone | 239-235-7908
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Fax |
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Provider Business Mailing Address
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Address Line | 950 MANATEE RD
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City | NAPLES
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State | FL
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Zip | 34114-8219
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Country | US
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Telephone | 239-235-7908
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARLOS PORTU
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Credential | MD
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Telephone | 954-993-3922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME103947
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License Number State | FL
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