PORT ORANGE INTERNISTS PA NPI 1689861205

NPI Information

  • NPI: 1689861205
  • Provider Name: PORT ORANGE INTERNISTS PA
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 3890 TURTLE CREEK DR
    PORT ORANGE, FL
    ZIP 32127
  • Phone: (386) 756-4400

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NPI Details

PORT ORANGE INTERNISTS PA is a family medicine in Port Orange, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PORT ORANGE INTERNISTS PA NPI is 1689861205. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3890 TURTLE CREEK DR
PORT ORANGE, FL
ZIP 32127-358
Phone: (386) 756-4400

The provider's authorized official is Souheil Moussly .
The authorized official title is Owner and has the following contact phone number (386) 756-4400.

The enumeration date for this NPI number is 9/27/2007 and was last updated on 9/27/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineME00050810FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1K2514MEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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