Individual
MR. THEODORE WILLIAM PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3000 E FLETCHER AVE, TAMPA, LA 33613
(813) 972-3774
(813) 971-8007
Mailing address
4404 W SEVILLA ST, TAMPA, FL 33629
(813) 837-9799
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS26975
FL
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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