OrganizationActive
Primary Care of Port Orange
NPI 1053861054 · Health Maintenance Organization · Port Orange, FL
Provider details
- NPI number
- 1053861054
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Michelle Gunter, Office Manager(386) 761-4670
- License
- 9308547 (FL)
Specialties & taxonomies
Managed Care Organizations
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4770 S Ridgewood Ave
Port Orange, FL 32127-4544
Phone: (386) 761-4670
Street-level locationGet directions
Mailing address
4770 S Ridgewood Ave
Port Orange, FL 32127-4544
Registry dates
- Enumerated
- 2016-10-13
- Last updated
- 2016-10-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.