Individual
MS. AMANDA RENEA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14555 CORTEZ BLVD, BROOKSVILLE, FL 34613-6003
(352) 556-4823
(352) 556-4824
Mailing address
5400 PINEHURST DR, SPRING HILL, FL 34606-3833
(352) 277-5348
(352) 606-2857
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107321
FL
Other
Enumeration date
06/27/2006
Last updated
12/22/2023
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