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NPI Code Detail

MEDICARE: TAYLOR DESTINY PORTZER MBA

MEDICARE: TAYLOR DESTINY PORTZER MBA
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
1171M00000XCase Manager/Care CoordinatorOH

General Provider Information

NPI Number : 1922966647
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR DESTINY PORTZER MBA
Provider Business Mailing Address
First Line : 5257 TRANSPORTATION BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44125-5332
Country : US
Telephone Number : 216-466-3675
Fax Number :
Provider Business Practice Location Address
First Line : 26055 EMERY RD STE K
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-6211
Country : US
Telephone Number : 216-466-3675
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “ TAYLOR DESTINY PORTZER MBA” Practice Location

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