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General NPI Number Information
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NPI Number | 1154646099
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Entity Type | Individual
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Provider Name | KINGA PORTER D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/04/2010
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 6272 LAKE OSPREY DR
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34240-8425
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Country | US
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Telephone | 941-666-8757
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Fax | 941-348-1421
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Provider Business Mailing Address
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Address Line | 11161 STATE ROAD 70 E UNIT 110
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-9407
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Country | US
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Telephone | 941-290-5400
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Fax | 941-289-2492
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS12305
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS 12305
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License Number State | FL
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