Provider Demographics
NPI:1154361574
Name:TORRES-PORTALATIN, GILDA (MD)
Entity type:Individual
Prefix:DR
First Name:GILDA
Middle Name:
Last Name:TORRES-PORTALATIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4165 SW 190TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2760
Mailing Address - Country:US
Mailing Address - Phone:954-441-7047
Mailing Address - Fax:
Practice Address - Street 1:4861 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3939
Practice Address - Country:US
Practice Address - Phone:305-826-7787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57836208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics