Provider Demographics
NPI:1225400757
Name:GONZALEZ PORTILLO, GIULLIANA MARIA (CRNP)
Entity Type:Individual
Prefix:
First Name:GIULLIANA
Middle Name:MARIA
Last Name:GONZALEZ PORTILLO
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:2333 ONTARIO RD NW
Mailing Address - Street 2:ATTN: MARANGELY NAZARIO
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2627
Mailing Address - Country:US
Mailing Address - Phone:202-420-7175
Mailing Address - Fax:202-232-2745
Practice Address - Street 1:2333 ONTARIO RD NW
Practice Address - Street 2:ATTN: MARANGELY NAZARIO
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2627
Practice Address - Country:US
Practice Address - Phone:202-420-7175
Practice Address - Fax:202-232-2745
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR218295363LP0200X
VA0024178826.363LP0200X
DCRN1038874363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics