Porter, Phyllis Diane
Porter, Phyllis Diane is an sole proprietor health care provider with primary practice located at 6650 103Rd St Apt 401, Jacksonville FL 32210-7143. She recently has only one registered license in Agencies / Day Training, Developmentally Disabled Services, which is considered as her primary health care specialty. Porter, Phyllis Diane can be contacted via phone (904) 559-5434.Contact Information
Primary practice address
6650 103Rd St Apt 401
Jacksonville FL 32210-7143
Phone: (904) 559-5434
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Day Training, Developmentally Disabled Services | 251C00000X | 000809200 | Florida |
Profile Details
| NPI number | 1952842528 |
|---|---|
| LBN Legal business name | Porter, Phyllis Diane |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 16th, 2017 |
| Last updated | Mar 16th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952842528 | NPPES |
| Florida | MEDICAID | 000809200 |
Popular Providers
-
Davis, Shawan
6700 Bowden Road Unit 1104 , Jacksonville FL 32216 -
Pinckney, Brian
1823 University Blvd S , Jacksonville FL 32216-8930 -
Williams, Erica C
1026 Gallant Fox Cir S , Jacksonville FL 32218-1955 -
Roberts, Deana
3954 Anderson Woods Dr , Jacksonville FL 32218-9218 -
Simmons, Latonia Delores
12428 Cadley Cir , Jacksonville FL 32219-1861 -
Grant, Joshua R
2405 Almeda St , Jacksonville FL 32209-4632 -
Scott, Traci Danielle
2211 Burpee Dr , Jacksonville FL 32210-3728 -
Fleming, Tahnita
2304 Burpee Dr W , Jacksonville FL 32210-3739