Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

East Volusia Family Practice PA

Organization Family Medicine Physician · NPI 1053384610

East Volusia Family Practice PA is a Family Medicine Physician in Port Orange, Florida. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

3911 S Nova Rd
Port Orange, FL 32127-4910
Phone: (386) 322-0811
Fax: (386) 761-5449
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1053384610
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lane Jennings — President · (386) 322-0811
NPI enumeratedFebruary 13, 2006
Last updated in NPPESJuly 9, 2008
Mailing address3911 S Nova Rd, Port Orange, FL 32127-4910

Other providers in Port Orange