MEDICARE: DR. FREDERIC FRANK PORCASE II D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS3927	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080148957	OTHER	FL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376569350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERIC FRANK PORCASE II D.O.

Provider Business Mailing Address
First Line	:	7855 ARGYLE FOREST BLVD.
Second Line	:	STE. 101
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-5597
Country	:	US
Telephone Number	:	904-282-6331
Fax Number	:	904-282-4117

Provider Business Practice Location Address
First Line	:	14011 BEACH BLVD
Second Line	:	SUITE 120
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-1507
Country	:	US
Telephone Number	:	904-223-6400
Fax Number	:	904-223-6420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/07/2017

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Directions to “ DR. FREDERIC FRANK PORCASE II D.O.” Practice Location

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