DR. MANUEL PORTALATIN (NPI# 1255309332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255309332 |
| Entity Type | Individual |
| Full Name | DR. MANUEL PORTALATIN |
| Credential | MD |
| Practice Address |
9090 Regency Square Blvd Credentialing Department Jacksonville FL 32211-8119 |
| Mailing Address |
Po Box 45443 Salt Lake City UT 84145-0443 |
| Practice Telephone | 9047245576 |
| Practice Fax Number | 9047240721 |
| Mailing Telephone | 9042021032 |
| Mailing Fax Number | 9043764107 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2018-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME66899 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710392246 | Manuel Enrique Portalatin | Surgery | 55 Fruit St, Boston, MA 02114-2621 | 2014-06-23 |
| Street Address |
9090 REGENCY SQUARE BLVD CREDENTIALING DEPARTMENT |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32211-8119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629054978 | Jeffry D Altomare | Pediatrics | 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 | 2005-12-19 |
| 1649823477 | Kristina Ashley Pound Butler | Nurse Practitioner | 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 | 2019-07-21 |
| 1447504527 | Belynda F Mccurry | Physician Assistant | 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 | 2012-10-29 |
| 1477832715 | Kristen Nicole Galloway | Psychologist | 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 | 2011-08-04 |
| 1912211905 | Nicholas D A Peterkin | Family Medicine | 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 | 2010-08-02 |
| 1073830725 | Muhammad A Ghazi | Family Medicine | 9090 Regency Square Blvd, Jacksonville, FL 32211 | 2010-04-21 |
| 1891976734 | Baptist Primary Care Inc | Internal Medicine | 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 | 2007-11-20 |
| 1720113533 | Thomas Mark Lundy | Physician Assistant | 9090 Regency Square Blvd, Credentialing Department, Jacksonville, FL 32211-8119 | 2007-02-22 |
| 1871523894 | Farah Malik | Family Medicine | 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 | 2006-07-04 |
| 1104894393 | James A Waler | Pediatrics | 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 | 2006-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951758 | Ebs Childrens Therapy - Fl LLC | Behavioral Analyst | 5491 Dolphin Point Blvd, Jacksonville, FL 32211 | 2020-10-27 |
| 1700412822 | Marie Vernal | Social Worker | 6051 Arlington Expressway Suite 169, Jacksonville, FL 32211 | 2020-03-20 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| 1366089641 | Prophetic Healing Deliverance Ministry of Mysteries, Inc | Counselor | 8550-2 Lone Star Road, Jacksonville, FL 32211 | 2019-12-05 |
| 1922656370 | Timothy Richard Barron | Behavior Technician | 5633 Clifton Ln, Jacksonville, FL 32211 | 2019-08-29 |
| 1023583325 | Linnzi Marks | Behavioral Analyst | 6014 Wateredge Ln, Jacksonville, FL 32211 | 2018-10-12 |
| 1780160192 | Ganesh Healthcare of Jax LLC | Alzheimer Center (Dementia Center) | 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 | 2018-07-18 |
| 1902397276 | Chandra Harris Washington | In Home Supportive Care | 2712 Gaillardia Rd, Jacksonville, FL 32211 | 2018-05-22 |
| 1043730062 | Monica R Iskander | Dentist | 465 University Blvd N, Jacksonville, FL 32211 | 2017-06-21 |
| 1205366895 | Lilibeth Bundang Adona | Custodial Care Facility | 1818 Townsend Blvd, Jacksonville, FL 32211 | 2017-06-15 |
| Find all providers in zip 32211 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676186 | Sarah Colleen Tapscott | Family Medicine | 1908 Mill Creek Rd, Jacksonville, FL 32211-5052 | 2020-07-20 |
| 1790303170 | Samantha L Scott | Family Medicine | 516 Pierce Ln, Jacksonville, TX 75766-4546 | 2020-07-11 |
| 1689298689 | Meridian Spine and Joint, Inc | Family Medicine | 9770 Old Baymeadows Rd Ste 139, Jacksonville, FL 32256-7986 | 2020-06-04 |
| 1154942563 | Families First Medical Group | Family Medicine | 12086 Fort Caroline Rd Ste 103, Jacksonville, FL 32225-2688 | 2020-04-27 |
| 1598396392 | Pareto Population Health Management Practice Pllc | Family Medicine | 1697 Kings Rd Ste 1, Jacksonville, FL 32209-6169 | 2020-01-30 |
| 1942862206 | Cindy S Wright Do Pllc | Family Medicine | 12627 San Jose Blvd Ste 902, Jacksonville, FL 32223-8645 | 2019-07-07 |
| 1942868377 | Pain Spine & Wellness LLC | Family Medicine | 9770 Old Baymeadows Rd Ste 141, Jacksonville, FL 32256-7986 | 2019-05-31 |
| 1669035705 | Kathy Jo Daniels | Family Medicine | 10457 Wellington Springs Way, Jacksonville, FL 32221-1175 | 2019-04-15 |
| 1821579103 | Tiffany N Major | Family Medicine | 5194 Johnson Creek Dr, Jacksonville, FL 32218-9308 | 2018-08-24 |
| 1568987360 | Main Street Health LLC | Family Medicine | 2 Shircliff Way Ste 620, Jacksonville, FL 32204-4762 | 2017-08-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32211 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.