Organization
PORTER PREMIER DERMATOLOGY AND SURGERY CENTER, PLLC
Active
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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