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General NPI Number Information
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NPI Number | 1952030389
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Entity Type | Individual
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Provider Name | GABRIELA PORTMANN DMD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 9200 113TH ST N
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City | SEMINOLE
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State | FL
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Zip | 33772-3377
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Country | US
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Telephone | 727-394-6065
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Fax |
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Provider Business Mailing Address
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Address Line | 7950 PARK BLVD N APT 4301
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3765
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Country | US
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Telephone | 772-696-3982
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN26930
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License Number State | FL
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