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General NPI Number Information
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NPI Number | 1336692284
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Entity Type | Organization
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Legal Business Name | JW PORTER CONSULTANTS LLC
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 6272 LAKE OSPREY DR
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34240-8425
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Country | US
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Telephone | 941-666-8757
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Fax | 941-348-1421
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Provider Business Mailing Address
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Address Line | 6272 LAKE OSPREY DR
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34240-8425
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Country | US
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Telephone | 941-666-8757
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | KINGA PORTER
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Credential | D.O
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Telephone | 941-666-8757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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