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NPI Code Detail

MEDICARE: DR. BARRY FRANKLIN PORTNOY M.D.

MEDICARE: DR. BARRY FRANKLIN PORTNOY M.D.
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
1207Q00000XFamily Medicine Physician0015367FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396768826
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARRY FRANKLIN PORTNOY M.D.
Provider Business Mailing Address
First Line : 494 SABAL TRAIL CIR
Second Line :
City : LONGWOOD
State : FL
Zip : 32779-6127
Country : US
Telephone Number : 407-916-4551
Fax Number : 407-916-4552
Provider Business Practice Location Address
First Line : 8701 MAITLAND SUMMIT BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32810-5915
Country : US
Telephone Number : 407-916-4551
Fax Number : 407-916-4552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/08/2007

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