ANTHONY JEROME PORTER (NPI# 1013957133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013957133 |
| Entity Type | Individual |
| Full Name | ANTHONY JEROME PORTER |
| Credential | MD |
| Practice Address |
1515 W Nasa Blvd Suite 101 Melbourne FL 32901-2605 |
| Practice Telephone | 3213080659 |
| Practice Fax Number | 3213092881 |
| Mailing Telephone | 3213080659 |
| Mailing Fax Number | 3213092881 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME96233 | FL | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 01058940A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 55044 | 01 |
| FL | WELLCARE | 246877 | 01 |
| FL | AETNA | 1358244 | 01 |
| FL | AETNA | 7650363 | 01 |
| FL | 276029100 | 05 | |
| FL | RAILROAD MEDICARE | P00415676 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447715909 | Anthony Porter | Specialist/Technologist | 204 Airy Springs Rd, Easley, SC 29642-8798 | 2019-02-08 |
| 1063945087 | Anthony Porter | Counselor | 55 Troup St, Rochester, NY 14608-2053 | 2017-04-06 |
| 1679869515 | Anthony J. Porter Jr. | Orthopaedic Surgery | 4626 Willow Rd, Pleasanton, CA 94588 | 2011-06-20 |
| Street Address |
1515 W NASA BLVD SUITE 101 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881925006 | Leavitt Medical Associates of Florida Inc | Dermatology | 1515 W Nasa Blvd, Ste 100, Melbourne, FL 32901-2605 | 2010-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205290913 | Megan Marie Cronin | Dermatology | 1399 S. Harbor City Blvd, Melbourne, FL 32901-3208 | 2016-04-08 |
| 1912217928 | Stuart A Walek Md Pa | Dermatology | 4314 Ligustrum Dr, Melbourne, FL 32934-8603 | 2010-10-12 |
| 1104152495 | Porter Premier Dermatology and Surgery Center, Pllc | Dermatology | 1515 W Nasa Blvd Ste 101, Melbourne, FL 32901-2605 | 2009-10-22 |
| 1174614663 | Stephen H Hornell | Dermatology | 333 E Sheridan Rd, Melbourne, FL 32901-3152 | 2006-09-27 |
| 1942227814 | Sandra K Shrader | Dermatology | 1700 W Hibiscus Blvd, Melbourne, FL 32901-2615 | 2006-07-16 |
| 1023046885 | Peter Mangone Zies | Dermatology | 17 East Silver Palm Avenue, Melbourne, FL 32901-3123 | 2006-06-29 |
| 1275594277 | Rosalind A Freas | Dermatology | 2571 W Eau Gallie Blvd, Suite 2, Melbourne, FL 32935-8954 | 2006-03-29 |
| 1598732471 | Stacia Poole | Dermatology | 930s Harbor City Blvd 101, Melbourne, FL 32901-1901 | 2006-03-01 |
| 1447234000 | Anita Saluja | Dermatology | 6559 N Wickham Rd Ste C-105, Melbourne, FL 32940-2039 | 2005-12-06 |
| 1255325049 | Larry S Bishop | Dermatology | 7125 Murrell Rd, Melbourne, FL 32940-7999 | 2005-09-07 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.