Individual
EDWARD JEROME PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2925 NW 4TH AVE, OCALA, FL 34475-2645
(352) 258-4015
(215) 559-6336
Mailing address
2925 NW 4TH AVE, OCALA, FL 34475-2645
(352) 258-4015
(215) 559-6336
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2681892
FL
372600000X
Adult Companion
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016981800
—
FL
05
—
679698296
—
FL
Enumeration date
11/12/2016
Last updated
06/22/2017
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