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General NPI Number Information
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NPI Number | 1720168826
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Entity Type | Individual
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Provider Name | MARK ANTONY LAPORTA MD
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 13305 ROSELAND ROAD #456 MARK ANTONY LAPORTA MD FACP LOCUMS NOT PATIENTS
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City | ROSELAND
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State | FL
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Zip | 32957-0456
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Country | US
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Telephone | 772-388-9595
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 456
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City | ROSELAND
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State | FL
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Zip | 32957-0456
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Country | US
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Telephone | 772-388-9595
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | FLME0041885
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME41885
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License Number State | FL
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