Audrey Alanna Port, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN25212 Issued in FL

Practice address

3502 Avalon Park West Blvd
Orlando, FL 32828-7859

Phone

(407) 392-9868

NPI assigned

May 27, 2020

Last updated

Jul 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Networks

• Freedom Health HMO Network

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1184247025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 NATURE EAST DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288049",
            "telephone_number": "804-432-9728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 AVALON PARK WEST BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287859",
            "telephone_number": "407-392-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORT",
        "first_name": "AUDREY",
        "middle_name": "ALANNA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Porco
• Kristian Marie Porco, MSOTR/L
• Poris Plastic Surgery, LLC
• Stephenie Layne Poris, M.D.
• Alyzza Leslie Porrata-Doria, SLPA
• Porta Nova Homemaker Companion Services (Porta Nova Nurse Registry)
• Porta Nova Homemaker Companion Services, LLC
• Anais Portal Lumpuy
• David Portee, MD
• Odelaidys Portela Semanat

• General Practice Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.