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Organization

MARK PORTER ED D CAP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK PORTER ED.D., CAP (PRESIDENT)
(941) 955-5454
Entity
Organization

Contact information

Practice address
240 N WASHINGTON BLVD, SUITE 304, SARASOTA, FL 34236-5945
(941) 955-5454
Mailing address
240 N WASHINGTON BLVD, SUITE 304, SARASOTA, FL 34236-5945
(941) 955-5454

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PY4711
FL

Other

Enumeration date
11/19/2010
Last updated
11/19/2010
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