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NPI Code Detail

MEDICARE: JULIA NICOLE PORTER

MEDICARE:   JULIA NICOLE PORTER
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
1208600000XSurgery Physician0019993FL

General Provider Information

NPI Number : 1831698711
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA NICOLE PORTER
Provider Business Mailing Address
First Line : 7802 NW 103RD ST # 109
Second Line :
City : HIALEAH GARDENS
State : FL
Zip : 33016-2400
Country : US
Telephone Number : 786-461-1072
Fax Number :
Provider Business Practice Location Address
First Line : 7802 NW 103RD ST # 109
Second Line :
City : HIALEAH GARDENS
State : FL
Zip : 33016-2400
Country : US
Telephone Number : 786-461-1072
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2018
Last Update Date : 01/13/2026

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Directions to “ JULIA NICOLE PORTER ” Practice Location

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