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General NPI Number Information
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NPI Number | 1447946017
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Entity Type | Organization
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Legal Business Name | ANTHONY PORTUGAL PLLC
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 4600 LINTON BLVD STE 100
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6600
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Country | US
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Telephone | 954-829-3442
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Fax |
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Provider Business Mailing Address
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Address Line | 2770 NE 53RD CT
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064-7856
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Country | US
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Telephone | 954-829-3254
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY PORTUGAL
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Credential | CRNA
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Telephone | 954-829-3442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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