Porter, Wayne Randolph

Porter, Wayne Randolph is an individual health care provider with primary practice located at 909 N Miami Beach Blvd Suite 403, North Miami Beach FL 33162-3712. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Porter, Wayne Randolph can be contacted via phone (305) 949-4223.

Contact Information

Primary practice address
909 N Miami Beach Blvd Suite 403 North Miami Beach FL 33162-3712
Phone: (305) 949-4223
Fax: (305) 949-9329
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME0023205 Florida

Profile Details

NPI number 1346280682
LBN Legal business name Porter, Wayne Randolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346280682 NPPES
Florida Other 92706 BLUE CROSS BLUE SHIELD FL
Florida Other ME0023205 BLUE CROSS BLUE SHIELD FL

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