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General NPI Number Information
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NPI Number | 1396680955
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Entity Type | Organization
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Legal Business Name | PORTIER MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 560 W BROWN RD STE 3001
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City | MESA
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State | AZ
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Zip | 85201-3225
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Country | US
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Telephone | 928-397-7226
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Fax |
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Provider Business Mailing Address
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Address Line | 7630 LIVE OAK DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-6032
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RAASHIDA PORTIER
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Credential |
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Telephone | 928-397-7226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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