Anthony Jerome Porter (NPI# 1013957133, PAC ID# 9739152927) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1013957133 |
| PAC ID by PECOS | 9739152927 |
| Professional Enrollment ID | I20070123000043 |
| Full Name | Anthony Jerome Porter |
| Organization Legal Name | PORTER PREMIER DERMATOLOGY AND SURGERY CENTER, PLLC |
| Address |
1515 W Nasa Blvd Suite 100 Melbourne FL 32901-2605 |
| Phone Number | 3213080659 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Graduation Year | 1998 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 0749562452 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100019 | HOLMES REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1515 W Nasa Blvd, Suite 100, Melbourne, FL 32901-2605 | 3213080659 | PORTER PREMIER DERMATOLOGY AND SURGERY CENTER, PLLC |
| Organization Legal Name | PORTER PREMIER DERMATOLOGY AND SURGERY CENTER, PLLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christian A Staniec | Physician Assistant | Porter Premier Dermatology and Surgery Center, Pllc | 1515 W Nasa Blvd, Suite 100, Melbourne, FL 32901-2605 |
| Street Address |
1515 W NASA BLVD SUITE 100 |
| City | MELBOURNE |
| State | FL |
| Zip | 32901-2605 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christian A Staniec | Physician Assistant | Porter Premier Dermatology and Surgery Center, Pllc | 1515 W Nasa Blvd, Suite 100, Melbourne, FL 32901-2605 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony R Else | Physical Therapy | 18 W Ave 'b' Unit, Suite 4, Melbourne, FL 32901-1219 | |
| Yanqing Gu | Internal Medicine | 551 S Apollo Blvd, Suite 103, Melbourne, FL 32901-1274 | |
| Richard J Wecker | Chiropractic | 551 S Apollo Blvd, Suite 105, Melbourne, FL 32901-1274 | |
| Ralph Zipper | Urology | Ralph Zipper Md Pa | 200 S Harbor City Blvd, Suite 401, Melbourne, FL 32901-1389 |
| James Loras Raders | Obstetrics/gynecology | Ralph Zipper Md Pa | 200 S Harbor City Blvd, Suite 401, Melbourne, FL 32901-1389 |
| Brian J Mallette | Podiatry | 200 S Harbor City Blvd, Suite 102, Melbourne, FL 32901-1389 | |
| Claudia R Mallette | Podiatry | 200 S Harbor City Blvd, Suite 102, Melbourne, FL 32901-1389 | |
| Ana Marisol Conde Rosa | Infectious Disease | Project Response Inc | 745 S Apollo Blvd, Melbourne, FL 32901-1457 |
| Monica L Wise | Nurse Practitioner | Quality Medical Care Pa | 675 S Babcock St, Melbourne, FL 32901-1459 |
| Heather M Weeks | Nurse Practitioner | Quality Medical Care Pa | 675 S Babcock St, Melbourne, FL 32901-1459 |
| Find all physicians in zip 32901 | |||
| City | MELBOURNE |
| Zip Code | 32901 |
| Specialty | DERMATOLOGY |
| City + Specialty | MELBOURNE + DERMATOLOGY |
Please comment or provide details below to improve the information on Anthony Jerome Porter.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.