Individual
CASEY MARK PORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
919 NE 13TH ST, FORT LAUDERDALE, FL 33304-2009
(954) 763-2030
(954) 467-5844
Mailing address
919 NE 13TH ST, FORT LAUDERDALE, FL 33304-2009
(954) 763-2030
(954) 467-5844
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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