Provider Demographics
NPI:1336822501
Name:BORTE, MIA
Entity Type:Individual
Prefix:MS
First Name:MIA
Middle Name:
Last Name:BORTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 ARLINGTON PL
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3811
Mailing Address - Country:US
Mailing Address - Phone:757-739-6100
Mailing Address - Fax:
Practice Address - Street 1:4005 ARLINGTON PL
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3811
Practice Address - Country:US
Practice Address - Phone:757-739-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula