Individual provider Active NPI

Summer Denmark

  • Pediatric Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1144536202
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
9233639 Issued in FL
Practice address
815 Woodbury Rd
Suite 102
Orlando, FL 32828-4515
Phone
(407) 208-9870
Fax
(407) 208-9868
NPI assigned
Aug 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 9233639 FL Primary

Addresses

Primary practice location

815 Woodbury Rd
Suite 102
Orlando, FL 32828-4515

Mailing address

17709 Sterling Pond LN
Orlando, FL 32820-2286
Phone (407) 208-9870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120615000153 FL Practitioner - Nurse Practitioner 4880858299 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9233639FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Florida Inc CurrentSince Jul 26, 2017 Accepting new patients
Lee Vista Pediatrics Past Accepting new patients

Locations

3100 SW 62nd Ave
Miami, FL 33155
Phone (305) 669-5873

1901 SW 172nd Ave
Miramar, FL 33029
Phone (954) 276-5401

12969 S US 301
Riverview, FL 33578
Phone (813) 971-6909

1300 Sawgrs Corp Pkwy
Ste 200
Sunrise, FL 33323
Phone (954) 384-0175

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1144536202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17709 STERLING POND LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328202286",
            "telephone_number": "407-208-9870",
            "fax_number": "407-208-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 WOODBURY RD",
            "address_2": "SUITE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284515",
            "telephone_number": "407-208-9870",
            "fax_number": "407-208-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENMARK",
        "first_name": "SUMMER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "9233639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.