1043651250 NPI number — MRS. VANESSA MARIA PORTILLA M.A.

Table of content: MRS. VANESSA MARIA PORTILLA M.A. (NPI 1043651250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043651250 NPI number — MRS. VANESSA MARIA PORTILLA M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PORTILLA
Provider First Name:
VANESSA
Provider Middle Name:
MARIA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043651250
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
E2 JARD MARIBEL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AGUADILLA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00603-5603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-224-0214
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
EDIFICO LA CURVA PROFESSIONAL PLAZA AVE MILITAR 3081
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
ISABELA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-373-7155
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC1900X , with the licence number:  3801 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com