Provider Demographics
NPI:1811395841
Name:PORTELA-BERRIOS, JOSE EMILIO (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:EMILIO
Last Name:PORTELA-BERRIOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11400 LITTLE NELLIE DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8668
Mailing Address - Country:US
Mailing Address - Phone:352-223-7227
Mailing Address - Fax:352-708-5334
Practice Address - Street 1:192 W HWY 50
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3078
Practice Address - Country:US
Practice Address - Phone:352-708-5333
Practice Address - Fax:352-708-5334
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor