Individual
TOM PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
141 WEBB DR, STE. 200, DAVENPORT, FL 33837-3951
(863) 422-0020
(863) 422-0021
Mailing address
141 WEBB DR, STE. 200, DAVENPORT, FL 33837-3951
(863) 422-0020
(863) 422-0021
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME78730
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME78730
FL
208VP0000X
Pain Medicine Physician
ME78730
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
ME78730
FL
Other
Enumeration date
09/23/2005
Last updated
07/15/2010
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