Grace Medical Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GRACE MEDICAL CLINIC

Practice address

2300 W Oakland Park Blvd
Unit 900
Oakland Park, FL 33311-1422

Phone

(772) 361-3051

NPI assigned

Apr 13, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Fredo Saint Charles

Title

Partner

Phone

(772) 361-3051

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1124472360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W OAKLAND PARK BLVD",
            "address_2": "UNIT 900",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111422",
            "telephone_number": "772-361-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W OAKLAND PARK BLVD",
            "address_2": "UNIT 900",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111422",
            "telephone_number": "772-361-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "SAINT CHARLES",
        "authorized_official_first_name": "FREDO",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "772-361-3051",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Miriam Gordon, DMD
• Peter Gorobetz, L.M.T.
• Kavir Gosine, ARNP
• Jessica Gousse
• Grace for All LLC
• Grace Medical Clinic, LLC
• Lynnette L Granger, M.S CCC-SLP
• Gravity 21 Fort Lauderdale, LLC
• Darlene Gray, CCC-SLP
• Jhonnarri Gray

• Primary Care Clinic/Center in Oakland Park, FL
• Providers in Oakland Park, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.