Individual provider · Type 1 NPI
Lakeisha L. Porter, PA-C
Medical Physician Assistant · Temple Terrace, FL
NPI number
1063417889
Active
Practice location
13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Fax (813) 972-5055
Mailing address
5802 N 30th St
Tampa, FL 33610-1469
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA9102987 (FL) |
Medical Physician Assistant: Definition to come...
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About NPI 1063417889
Lakeisha L. Porter, PA-C's National Provider Identifier is 1063417889, issued on Jun 17, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Temple Terrace, FL. The record was last updated on Jul 8, 2007.