Provider Demographics
NPI:1376569350
Name:PORCASE, FREDERIC FRANK II (DO)
Entity Type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:FRANK
Last Name:PORCASE
Suffix:II
Gender:M
Credentials:DO
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Mailing Address - Street 1:7855 ARGYLE FOREST BLVD.
Mailing Address - Street 2:STE. 101
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5597
Mailing Address - Country:US
Mailing Address - Phone:904-282-6331
Mailing Address - Fax:904-282-4117
Practice Address - Street 1:14011 BEACH BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-1507
Practice Address - Country:US
Practice Address - Phone:904-223-6400
Practice Address - Fax:904-223-6420
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2017-08-07
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Provider Licenses
StateLicense IDTaxonomies
FLOS3927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040812300Medicaid
FL080148957OtherMEDICARE RAILROAD
FL080148957OtherMEDICARE RAILROAD
FL040812300Medicaid