Organization Active NPI

American Sun Primary Care LLC

  • Family Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1104780709
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
AMERICAN SUN PRIMARY CARE LLC
Practice address
4063 N Goldenrod Rd Ste 3
Winter Park, FL 32792-8905
Phone
(203) 823-5055
NPI assigned
Dec 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Mrs. Diana Agosto, APRNNPI 1902895071
Title
Family Nurse Practitioner
Phone
(203) 823-5055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4063 N Goldenrod Rd Ste 3
Winter Park, FL 32792-8905

Mailing address

14211 Portrush Dr
Orlando, FL 32828-8243
Phone (203) 823-5055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260512003269 FL Part B Supplier - Clinic/Group Practice 9032688791 Receives reassigned benefits from 1 practitioner
Practice locations: Winter Park, FL

National Provider Directory

National Provider Directory

Locations

4063 N Goldenrod Rd
Ste 103
Winter Park, FL 32792

4063 N Goldenrod Rd
Ste 3
Winter Park, FL 32792
Phone (203) 823-5055

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1765324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1104780709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14211 PORTRUSH DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288243",
            "telephone_number": "203-823-5055",
            "fax_number": "203-823-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4063 N GOLDENROD RD STE 3",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327928905",
            "telephone_number": "203-823-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN SUN PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-10",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "AGOSTO",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "203-823-5055",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.