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NPI Code Detail

MEDICARE: ANTHONY GABRIEL PORTUGAL CRNA

MEDICARE: ANTHONY GABRIEL PORTUGAL CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN9265082FL
2207L00000XAnesthesiology PhysicianAPRN9265082FL
3367500000XCertified Registered Nurse AnesthetistAPRN9265082FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588934269
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY GABRIEL PORTUGAL CRNA
Provider Business Mailing Address
First Line : 2770 NE 53RD CT
Second Line :
City : LIGHTHOUSE POINT
State : FL
Zip : 33064-7856
Country : US
Telephone Number : 954-829-3254
Fax Number :
Provider Business Practice Location Address
First Line : 5352 LINTON BLVD
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33484-6514
Country : US
Telephone Number : 561-498-4440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2012
Last Update Date : 02/05/2026

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