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General NPI Number Information
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NPI Number | 1568154094
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Entity Type | Individual
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Provider Name | ANA BERTA DE LA PORTILLA MONTERO
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Gender | Female
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 14040 NW 7TH AVE
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City | MIAMI
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State | FL
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Zip | 33168-6809
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Country | US
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Telephone | 754-707-2250
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 SW 67TH LN
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City | MIRAMAR
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State | FL
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Zip | 33023-4811
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Country | US
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Telephone | 786-372-3819
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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