Organization
PORTER'S AULT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LASHANA MEDINA PORTER (ADMINISTRATOR)
(904) 381-8962
Entity
Organization
Contact information
Practice address
700 DAY AVE, JACKSONVILLE, FL 32205-5504
(904) 381-8962
(904) 381-8861
Mailing address
700 DAY AVE, JACKSONVILLE, FL 32205-5504
(904) 381-8962
(904) 381-8861
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
9068
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691302496
—
FL
05
—
691302498
—
FL
05
—
692088800
—
FL
Enumeration date
06/04/2008
Last updated
06/04/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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