Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MISS PHYLLIS DIANE PORTER
Active Sole ProprietorMISS PHYLLIS DIANE PORTER is a Behavioral Health, Residential healthcare provider located in JACKSONVILLE, Florida. NPI 1952842528 is currently active in the NPPES registry. Verify at CMS.
Behavioral Health, Residential · JACKSONVILLE, FL
Registration Details
- NPI Number
- 1952842528
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 16, 2017 (9.2317316564553 yrs)
- Last Updated
- Mar 16, 2017
- License
-
000809200 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6650 103RD STAPT 401JACKSONVILLE, FL, 322107143Browse FL providers · Browse ZIP 32210
- Phone
- 9045595434
- Primary Specialty
-
Behavioral Health, Residential
251C00000X
Other Behavioral Health, Residential Providers in JACKSONVILLE, FL
| Name | Credential | NPI |
|---|---|---|
| IDEAL PUGH | — | 1952616112 |
| LATONIA DELORES SIMMONS | — | 1841629243 |
| JOANNA JOHNSON | — | 1104378041 |
| DOROTHY WASHINGTON | — | 1013481720 |
| ERICA C WILLIAMS | — | 1174153852 |
| WANDARDA RAY | — | 1033885421 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.