Jose Salvador Portocarrero, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9847 Issued in FL

Practice address

9993 Town Lake Dr
Orlando, FL 32832-5836

Phone

(646) 430-3957

NPI assigned

Feb 22, 2011

Last updated

Jan 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640995200000",
    "number": "1417254715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9993 TOWN LAKE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328325836",
            "telephone_number": "646-430-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9993 TOWN LAKE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328325836",
            "telephone_number": "646-430-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTOCARRERO",
        "first_name": "JOSE",
        "middle_name": "SALVADOR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2022-01-01",
        "certification_date": "2022-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petagaye A Porter
• Sarah Porter, LMHC
• Valeria A Portillo
• Barry Franklin Portnoy, M.D.
• Yuniar Porto Jimenez, FNP
• Joseph D. Portoghese, MD
• Yesenia Portorreal, CNA
• Cassia Brasil Portugal, M.D.,FAAP
• Bibiam Posada
• Angel Dominique Posadas

• Clinical Psychologist in Orlando, FL
• Providers in Orlando, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.