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NPI Code Detail

MEDICARE: MICHAEL PORTER EMT

MEDICARE: MICHAEL PORTER EMT
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
1146N00000XBasic Emergency Medical Technician395034FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16035163OTHERFLHCCE

General Provider Information

NPI Number : 1912875055
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PORTER EMT
Provider Business Mailing Address
First Line : 6609 N SOCRUM LOOP RD
Second Line :
City : LAKELAND
State : FL
Zip : 33809-4182
Country : US
Telephone Number : 863-333-0119
Fax Number :
Provider Business Practice Location Address
First Line : 6609 N SOCRUM LOOP RD
Second Line :
City : LAKELAND
State : FL
Zip : 33809-4182
Country : US
Telephone Number : 863-333-0119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2025
Last Update Date : 10/29/2025

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Directions to “ MICHAEL PORTER EMT” Practice Location

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