Organization
PORTER PREMIER DERMATOLOGY AND SURGERY CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY JEROME PORTER M.D. (OWNER)
(321) 308-0659
Entity
Organization
Contact information
Practice address
1515 W NASA BLVD STE 101, MELBOURNE, FL 32901-2605
(321) 308-0659
(321) 309-2881
Mailing address
1515 W NASA BLVD STE 101, MELBOURNE, FL 32901-2605
(321) 308-0659
(321) 309-2881
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME96233
FL
Other
Enumeration date
10/22/2009
Last updated
03/17/2018
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