Individual
MR. JORGE PORTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASSAGE THERAPIST MA
Contact information
Practice address
1422 NW 7TH ST, MIAMI, FL 33125-3700
(305) 631-8080
Mailing address
1422 NW 7TH ST, MIAMI, FL 33125-3700
(305) 631-8080
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA62203
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA62203
MASSAGE THERAPIST
FL
Enumeration date
12/07/2017
Last updated
12/07/2017
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