Healthcare Provider Details

I. General information

NPI: 1154646099
Provider Name (Legal Business Name): KINGA PORTER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KINGA KOSNY D.O.

II. Dates (important events)

Enumeration Date: 04/04/2010
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6272 LAKE OSPREY DR
LAKEWOOD RANCH FL
34240-8425
US

IV. Provider business mailing address

11161 STATE ROAD 70 E UNIT 110
LAKEWOOD RANCH FL
34202-9407
US

V. Phone/Fax

Practice location:
  • Phone: 941-666-8757
  • Fax: 941-348-1421
Mailing address:
  • Phone: 941-290-5400
  • Fax: 941-289-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS12305
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS 12305
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: