Provider Demographics
NPI:1639928716
Name:PORRO, BRIANNA MARIE (BIRTH DOULA)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:PORRO
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 N LADONIA TER
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-5805
Mailing Address - Country:US
Mailing Address - Phone:352-229-7800
Mailing Address - Fax:
Practice Address - Street 1:2142 N LADONIA TER
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-5805
Practice Address - Country:US
Practice Address - Phone:352-229-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL202404451374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty