Active NPI
Marvin S Porter, M.D.
- Procedural Dermatology Physician
- Fort Myers, FL
National Provider Identifier
1346201001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- License
- ME0030385
- Practice address
- 8381 Riverwalk Park Blvd
Suite 101
Fort Myers, FL 33919-8760 - Phone
- (239) 936-5425
- Fax
- (239) 936-5176
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | ME0030385 | FL | Primary |
Addresses
Primary practice location
8381 Riverwalk Park Blvd
Suite 101
Fort Myers, FL 33919-8760
Mailing address
8381 Riverwalk Park Blvd
Suite 101
Fort Myers, FL 33919-8760
Phone (239) 936-5425
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79022 | Other | FL | BC BS OF FLA |
| 4199301 | Other | FL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0030385 | FL | MD | Procedural Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1346201001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8381 RIVERWALK PARK BLVD",
"address_2": "SUITE 101",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339198760",
"telephone_number": "239-936-5425",
"fax_number": "239-936-5176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8381 RIVERWALK PARK BLVD",
"address_2": "SUITE 101",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339198760",
"telephone_number": "239-936-5425",
"fax_number": "239-936-5176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "MARVIN",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "FL",
"license": "ME0030385",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF FLA",
"identifier": "79022",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4199301",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.