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

Port Orange Pediatrics P A

Organization Pediatrics Physician · NPI 1902084064

Port Orange Pediatrics P A is a Pediatrics Physician in Port Orange, Florida. Licensed in Florida. Registered with an NPI since 2008.

Licensed in
FL
In the registry since
2008

Practice location Address checks out

1720 Dunlawton Ave Ste 1
Port Orange, FL 32127-2915
Phone: (386) 322-5390
Show map & directions

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

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence ME0068668 (FL)

Record details

NPI number1902084064
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ruben Lopez — President · (386) 322-5390
NPI enumeratedJanuary 31, 2008
Last updated in NPPESJanuary 26, 2022
Certification dateJanuary 26, 2022
Mailing address1728 Dunlawton Ave Ste 1, Port Orange, FL 32127-2923

Other providers in Port Orange