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General NPI Number Information
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NPI Number | 1356646228
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Entity Type | Organization
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Legal Business Name | PORTA DEL SOL SURGICAL SERVICES INC
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 3650 NW 82ND AVE SUITE 201
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City | DORAL
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State | FL
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Zip | 33166-6658
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Country | US
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Telephone | 305-537-7272
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Fax | 305-537-7274
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Provider Business Mailing Address
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Address Line | 3650 NW 82ND AVE SUITE 201
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City | DORAL
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State | FL
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Zip | 33166-6658
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Country | US
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Telephone | 305-537-7272
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Fax | 305-537-7274
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORIO CABAN
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Credential | DPM
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Telephone | 305-537-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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