Provider Demographics
NPI:1669473013
Name:PORTNOY, DANA BIDDLE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:BIDDLE
Last Name:PORTNOY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E HILLSBORO BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4348
Mailing Address - Country:US
Mailing Address - Phone:954-419-9632
Mailing Address - Fax:954-419-9634
Practice Address - Street 1:1500 E HILLSBORO BLVD STE 210
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4348
Practice Address - Country:US
Practice Address - Phone:954-419-9632
Practice Address - Fax:954-419-9634
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2613242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS99293Medicare UPIN
FLE3623VMedicare PIN