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General NPI Number Information
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NPI Number | 1831698711
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Entity Type | Individual
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Provider Name | JULIA NICOLE PORTER
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Gender | Female
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Dates
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Enumeration Date | 02/06/2018
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 7802 NW 103RD ST # 109
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2400
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Country | US
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Telephone | 786-461-1072
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Fax |
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Provider Business Mailing Address
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Address Line | 7802 NW 103RD ST # 109
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2400
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Country | US
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Telephone | 786-461-1072
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0019993
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License Number State | FL
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