Healthcare Provider Details

I. General information

NPI: 1467776542
Provider Name (Legal Business Name): TONIA D PORCHIA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST 116B
MIAMI FL
33125-1624
US

IV. Provider business mailing address

807 CORAL RIDGE DR
CORAL SPRINGS FL
33071-4180
US

V. Phone/Fax

Practice location:
  • Phone: 305-575-7000
  • Fax:
Mailing address:
  • Phone: 954-755-0909
  • Fax: 954-755-5692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY 8068
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: