Provider Demographics
NPI:1154646099
Name:PORTER, KINGA (DO)
Entity Type:Individual
Prefix:DR
First Name:KINGA
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KINGA
Other - Middle Name:
Other - Last Name:KOSNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6272 LAKE OSPREY DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8425
Mailing Address - Country:US
Mailing Address - Phone:941-666-8757
Mailing Address - Fax:941-348-1421
Practice Address - Street 1:6272 LAKE OSPREY DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34240-8425
Practice Address - Country:US
Practice Address - Phone:941-666-8757
Practice Address - Fax:941-348-1421
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-04
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 12305207R00000X
FLOS12305208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine