Juan Carlos Portuondo, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN 10130 Issued in FL

Practice address

7150 W 20TH Ave Ste 102
Hialeah, FL 33016-5509

Phone

(305) 556-5600

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Palm Dental Center, PA

  dba Palm Center for Dental Specialties

  • General Practice Dentistry
  • Hialeah, FL
  • NPI 1043323587

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952425639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 W MCINTYRE ST",
            "city": "KEY BISCAYNE",
            "state": "FL",
            "postal_code": "331491861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 W 20TH AVE STE 102",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165509",
            "telephone_number": "305-556-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTUONDO",
        "first_name": "JUAN CARLOS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 10130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ida Orlanda Portela
• Raul Portela, MD
• Virginia Portela, APRN
• Dunia Portuondo Castillo
• Maria Karla Portuondo Hernandez
• Yaneisy Portuondo
• Odalys Porven Antigua
• Yeniffer Porven Tamarit
• Yadira Porven
• Pos Therapy Services, Corp

• Oral and Maxillofacial Surgery (Dentist) in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.