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General NPI Number Information
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NPI Number | 1093213126
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Entity Type | Individual
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Provider Name | MICHAEL PORRAS
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Gender | Male
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 3400 CORAL WAY STE 202
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City | MIAMI
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State | FL
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Zip | 33145-3053
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Country | US
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Telephone | 305-856-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 CORAL WAY STE 202
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City | MIAMI
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State | FL
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Zip | 33145-3053
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Country | US
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Telephone | 305-856-1999
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI3470
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 10154
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 20155
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License Number State | FL
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