Active NPI
Mariajose Portilla
- Physician Assistant
- Miami Beach, FL
National Provider Identifier
1487454302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 900-PA
- Practice address
- 6039 Collins Ave Apt 1118
Miami Beach, FL 33140-2252 - Phone
- (786) 348-8680
- NPI assigned
- Mar 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 900-PA | PR | Primary |
Addresses
Primary practice location
6039 Collins Ave Apt 1118
Miami Beach, FL 33140-2252
Mailing address
6039 Collins Ave Apt 1118
Miami Beach, FL 33140-2252
Phone (786) 348-8680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 900-PA | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742256000000",
"number": "1487454302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6039 COLLINS AVE APT 1118",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331402252",
"telephone_number": "786-348-8680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6039 COLLINS AVE APT 1118",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331402252",
"telephone_number": "786-348-8680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTILLA",
"first_name": "MARIAJOSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-18",
"last_updated": "2025-03-18",
"certification_date": "2025-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "900-PA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.