MEDICARE: DR. EUGENIO MULERO PORTELA M.D.

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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	10847	PR

General Provider Information

NPI Number	:	1669464517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENIO MULERO PORTELA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 10249
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00732-0249
Country	:	US
Telephone Number	:	787-652-9200
Fax Number	:	787-652-1829

Provider Business Practice Location Address
First Line	:	MAYAGUEZ MEDICAL CTR STE 117
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1560
Country	:	US
Telephone Number	:	787-652-9200
Fax Number	:	787-652-1829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	05/09/2025

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