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General NPI Number Information
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NPI Number | 1568347854
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Entity Type | Organization
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Legal Business Name | PORTORREAL HOME CARE AGENCY, LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 103B BROADWAY STE 201
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City | KISSIMMEE
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State | FL
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Zip | 34741-5713
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Country | US
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Telephone | 718-749-2993
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Fax | 321-219-8635
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Provider Business Mailing Address
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Address Line | 103B BROADWAY STE 201
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City | KISSIMMEE
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State | FL
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Zip | 34741-5713
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Country | US
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Telephone | 718-749-2993
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Fax | 321-219-8635
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. BETANIA FERMI PORTORREAL
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Credential | MBA
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Telephone | 321-697-2334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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