Provider Demographics
NPI:1285845545
Name:PORTILLO, SILVIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:SILVIA
Middle Name:
Last Name:PORTILLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 CALLE ALCALA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4344
Mailing Address - Country:US
Mailing Address - Phone:787-723-1360
Mailing Address - Fax:787-723-6247
Practice Address - Street 1:900 CALLE CERRA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-5104
Practice Address - Country:US
Practice Address - Phone:787-723-1360
Practice Address - Fax:787-723-6247
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29552163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse