Individual
MRS. PETAGAYE A PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1627 BURNHAM ST, ORLANDO, FL 32808-6011
(508) 648-1511
Mailing address
1627 BURNHAM ST, ORLANDO, FL 32808-6011
(508) 648-1511
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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