Provider Demographics
NPI:1659362424
Name:PORTMAN, DRINA GERALDINE (DNP, APRN-BC)
Entity Type:Individual
Prefix:MRS
First Name:DRINA
Middle Name:GERALDINE
Last Name:PORTMAN
Suffix:
Gender:F
Credentials:DNP, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 FULLERTON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-3552
Mailing Address - Country:US
Mailing Address - Phone:305-336-2711
Mailing Address - Fax:954-920-9855
Practice Address - Street 1:7406 FULLERTON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-3552
Practice Address - Country:US
Practice Address - Phone:305-336-2711
Practice Address - Fax:954-920-9855
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2621802363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302867400Medicaid
FLAPRN2621802OtherFLORIDA BOARD OF NURSING