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

Primary Care Center of Port Orange

Organization Family Medicine Physician · NPI 1295910834

Primary Care Center of Port Orange is a Family Medicine 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

4770 S Ridgewood Ave Ste 1
Port Orange, FL 32127-4544
Phone: (386) 761-0050
Fax: (386) 761-1167
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME0028054 (FL)

Record details

NPI number1295910834
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Jackson — Office Manager · (386) 761-0050
NPI enumeratedJanuary 2, 2008
Last updated in NPPESMarch 29, 2011
Mailing address4770 S Ridgewood Ave, Suite 1, Port Orange, FL 32127-4544

Other providers in Port Orange