L & L PORT ORANGE, LLC (NPI# 1043708050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043708050 |
| Entity Type | Organization |
| Organization Name | L & L PORT ORANGE, LLC |
| Other Organization Name | KEVIN MARVIN |
| Practice Address |
4904 S Clyde Morris Blvd Suite B Port Orange FL 32129 |
| Mailing Address |
3890 Turtle Creek Drive Suite A Port Orange FL 32127 |
| Practice Telephone | 3867889959 |
| Practice Fax Number | 3867889850 |
| Mailing Telephone | 3867615440 |
| Mailing Fax Number | 3867600474 |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |
| Authorized Official Name | DR. EUGENE JOSEPH LECOMPTE JR. (OWNER/MANAGER) |
| Authorized Official Telephone | 3862953815 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
DN12922 | FL | Ambulatory Health Care Facilities |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DN7283 | FL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kevin Marvin | Doing Business As Name - Organization |
| Street Address |
4904 S CLYDE MORRIS BLVD SUITE B |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528140670 | David W. Lowe | Dentist | 4904 S Clyde Morris Blvd, Suite A, Port Orange, FL 32129-4170 | 2006-10-19 |
| 1043416712 | Ramon Gutierrez | Acupuncturist | 4904 S Clyde Morris Blvd, Ste D2, Port Orange, FL 32129-4170 | 2007-06-21 |
| 1013113778 | Jack Verhees | Physical Therapist | 4904 S Clyde Morris Blvd, Ste D2, Port Orange, FL 32129-4170 | 2007-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750981452 | Smillie Dental Pllc | Clinic/Center | 5537 S Williamson Blvd Ste 675, Port Orange, FL 32128-8314 | 2020-10-30 |
| 1447702071 | Sondra L Avant Dds Ms Pa | Clinic/Center | 731 Dunlawton Ave Ste 105, Port Orange, FL 32127-4237 | 2016-10-31 |
| 1730329509 | Florida Institute of Orofacial Myology, LLC | Clinic/Center | 3930 S Nova Rd, Port Orange, FL 32127-9281 | 2009-03-05 |
| 1932373636 | J. Michael Panczyszyn, D.d.s., Pa | Clinic/Center | 938 Bridgewater Dr, Unit 3b, Port Orange, FL 32129-6108 | 2008-04-15 |
| 1730394263 | Harvinder S Chadda, B.d.s.,p.a. | Clinic/Center | 790 Dunlawton Ave, Suite F, Port Orange, FL 32127-9279 | 2007-05-10 |
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| 1811598238 | Dental Plus Management, LLC | Clinic/Center | 16 Ne 2nd Ave, Deerfield Beach, FL 33441-3504 | 2020-11-03 |
| 1609476027 | R & R Dentistry Pa | Clinic/Center | 6290 Linton Blvd Unit 202, Delray Beach, FL 33484-6409 | 2020-10-26 |
| 1295334126 | Friedman Dental Group Miami, Pllc | Clinic/Center | 1717 N Bayshore Dr Ste 219, Miami, FL 33132-1196 | 2020-10-21 |
| 1376142547 | Trm Global Enterprise,llc. | Clinic/Center | 145 Crawl Key Ct, Deland, FL 32720-3951 | 2020-10-20 |
| 1568060762 | Bawany LLC | Clinic/Center | 15130 Springview St, Tampa, FL 33624-2332 | 2020-10-12 |
| 1992312730 | Rocent Dental Care, Inc. | Clinic/Center | 1 Sw 129th Ave Ste 406, Pembroke Pines, FL 33027-1718 | 2020-09-25 |
| 1730795857 | Kind Smiles Dental Health | Clinic/Center | 11155 State Road 70 E, Lakewood Ranch, FL 34202 | 2020-09-23 |
| 1952916306 | Simmons Services LLC | Clinic/Center | 2500 Sw 107th Ave Ste 45, Miami, FL 33165-2492 | 2020-09-12 |
| 1962017582 | 1 Step Dental | Clinic/Center | 7025 Beracasa Way Ste 203, Boca Raton, FL 33433-3444 | 2020-09-10 |
| Find all providers with the same taxonomy | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.