Provider Demographics
NPI:1205019171
Name:WESTLAND PEDIATRICS
Entity Type:Organization
Organization Name:WESTLAND PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES-PORTALATIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-826-7787
Mailing Address - Street 1:4861 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3939
Mailing Address - Country:US
Mailing Address - Phone:305-826-7787
Mailing Address - Fax:
Practice Address - Street 1:4861 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3939
Practice Address - Country:US
Practice Address - Phone:305-826-7787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center