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General NPI Number Information
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NPI Number | 1154159275
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Entity Type | Individual
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Provider Name | FARBENZIE TCHESKA PORTER
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 130 PABLO ST
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City | LAKELAND
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State | FL
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Zip | 33803-3818
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Country | US
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Telephone | 863-284-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 8323 DOVE BOG TER
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City | PARRISH
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State | FL
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Zip | 34219-5537
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Country | US
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Telephone | 941-301-5292
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11034182
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License Number State | FL
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