Primary Care Center of Port Orange
NPI #1295910834 in Port Orange, Florida
Provider Information
- NPI Number
- 1295910834
- Entity Type
- Organization
- Organization Name
- Primary Care Center of Port Orange
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jan 2, 2008
- Last Updated
- Mar 29, 2011
Practice Location
- Address
- 4770 S RIDGEWOOD AVE
- Address 2
- SUITE 1
- City
- Port Orange
- State
- Florida
- ZIP Code
- 32127-4544
- Phone
- (386) 761-0050
Authorized Official
- Name
- MS. MICHELLE L JACKSON
- Title
- OFFICE MANAGER
- Phone
- (386) 761-0050
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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