Organization
DELANEY PARK FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE D PORTER M.D. (OWNER)
(407) 423-2571
Entity
Organization
Contact information
Practice address
900 DELANEY AVE, ORLANDO, FL 32806-1246
(407) 423-2571
(407) 423-0028
Mailing address
1495 S VOLUSIA AVE, SUITE 102, ORANGE CITY, FL 32763-7047
(386) 774-5211
(386) 774-5251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME12701
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48590
BCBS
FL
Enumeration date
11/11/2008
Last updated
02/11/2009
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