Individual
DR. JASON E. PORTNOF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
9980 CENTRAL PARK BLVD N STE 113, BOCA RATON, FL 33428-1703
(561) 717-3660
(561) 717-3650
Mailing address
9980 CENTRAL PARK BVLD N, SUITE 113, BOCA RATON, FL 33428
(561) 717-3660
(561) 717-3650
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DN16048
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
ME101326
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008090701
—
FL
Enumeration date
07/29/2009
Last updated
03/14/2024
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