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NPI Code Detail

MEDICARE: PORTIA F BOATWRIGHT INC

MEDICARE: PORTIA F BOATWRIGHT INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner

General Provider Information

NPI Number : 1811580996
Entity Type Code : Organization
Provider Name (Legal Business Name) : PORTIA F BOATWRIGHT INC
Provider Business Mailing Address
First Line : 2225 SW NEWPORT ISLES BLVD
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34953-4575
Country : US
Telephone Number : 561-633-0104
Fax Number : 888-411-5724
Provider Business Practice Location Address
First Line : 2225 SW NEWPORT ISLES BLVD
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34953-4575
Country : US
Telephone Number : 561-633-0104
Fax Number : 888-411-5724
Authorized Official
Title or Position : PRESIDENT
Name : MRS. PORTIA FIERRA WILLIAMS
Credential : APRN
Telephone Number : 561-633-0104
Provider Enumeration Date : 02/18/2021
Last Update Date : 11/09/2021

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