PRIMARY CARE CENTER OF PORT ORANGE
NPI 1295910834
Family Medicine in Port Orange, FL

Active since January 02, 2008
4770 S RIDGEWOOD AVE, SUITE 1, PORT ORANGE, FL 32127(386) 761-0050(386) 761-1167 Get Directions Write a Review

NPPES record last updated: March 29, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Primary Care Center Of Port Orange NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMARY CARE CENTER OF PORT ORANGE (NPI 1295910834) is a healthcare organization registered as a family medicine in Port Orange, Florida and active in the NPI registry since January 2008. The organization lists Michelle L Jackson, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1295910834
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRIMARY CARE CENTER OF PORT ORANGE
Location Address4770 S RIDGEWOOD AVE, SUITE 1Port Orange, FL 32127-4544
Mailing Address4770 S Ridgewood Ave, Suite 1Port Orange, FL 32127-4544 · (386) 761-0050 · Fax (386) 761-1167
Fax(386) 761-1167
Organization SubpartNo
Authorized OfficialMichelle L JacksonOffice Manager · (386) 761-0050
Enumeration DateJanuary 2, 2008
Last NPPES UpdateMarch 29, 2011
NPI 1295910834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in FL · ME0028054
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4770 S RIDGEWOOD AVE, Port Orange, FL 32127

Other Identifiers 1

Medicare PINK2665FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Health Maintenance Organization
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Nurse Practitioner (Family)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Counselor (Mental Health)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Counselor (Mental Health)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Counselor (Mental Health)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127
Counselor (Mental Health)
4770 S RIDGEWOOD AVE
PORT ORANGE, FL 32127

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Primary Care Center Of Port Orange's NPI number?

The NPI number for Primary Care Center Of Port Orange is 1295910834. It was assigned to this organization in the NPPES registry on January 2, 2008.

Where is Primary Care Center Of Port Orange located?

Primary Care Center Of Port Orange is located at 4770 S Ridgewood Ave Suite 1, Port Orange, FL 32127. The listed phone number is (386) 761-0050.

What is Primary Care Center Of Port Orange's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Primary Care Center Of Port Orange was last updated on March 29, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.