Individual
BRANDON EMIL PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5340 SOUTEL DR, JACKSONVILLE, FL 32219-3478
(904) 764-1773
(904) 764-3034
Mailing address
5340 SOUTEL DR, JACKSONVILLE, FL 32219-3478
(904) 764-1773
(904) 764-3034
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS5879
FL
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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