Organization
GUILLERMO F PORRO DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA I PROSPERE (OFFICE MANAGER)
(813) 889-8599
Entity
Organization
Contact information
Practice address
7059 W WATERS AVE, TAMPA, FL 33634-2290
(813) 889-8599
(813) 249-1301
Mailing address
7059 W WATERS AVE, TAMPA, FL 33634-2290
(813) 889-8599
(813) 249-1301
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
10372
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074901001
—
FL
Enumeration date
01/19/2012
Last updated
01/19/2012
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