Individual provider Active NPI

Christine Lynn Gramaglia, OTR

  • Pediatric Occupational Therapist
  • Eustis, FL
National Provider Identifier
1093860447
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT7647 Issued in FL
Practice address
437 West Ardice Ave
Eustis, FL 32726
Phone
(352) 505-4754
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT7647 FL Primary

Addresses

Primary practice location

437 West Ardice Ave
Eustis, FL 32726

Mailing address

437 West Ardice Ave
Eustis, FL 32726-6816
Phone (352) 505-4754

Other practice location 1

2400 S. Hwy 27
Suite B201
Clermont, FL 34711-3471
Phone (352) 223-0212 ext. 14

Other identifiers 1

IdentifierTypeStateIssuer
887155800MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL info@cfldreamplex.com Direct
CONNECT URL Clermont Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT7647FLMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1093860447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 WEST ARDICE AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266816",
            "telephone_number": "352-505-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 WEST ARDICE AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "32726",
            "telephone_number": "352-505-4754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S. Hwy 27",
            "address_2": "Suite B201",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347113471",
            "country_code": "US",
            "telephone_number": "352-223-0212 x14",
            "fax_number": "352-241-6361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAMAGLIA",
        "first_name": "CHRISTINE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT7647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887155800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@cfldreamplex.com",
            "affiliation": "N",
            "endpointDescription": "info@cfldreamplex.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2400 S Hwy 27 Ste B201",
            "city": "Clermont",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347116816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Clermont",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2400 S. Hwy 27",
            "address_2": "Suite B201",
            "city": "Clermont",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347113471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.