Gracious Mind P.a.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY7910 Issued in FL

Legal business name

GRACIOUS MIND P.A.

Practice address

1625 N Commerce Pkwy
Suite 210
Weston, FL 33326-3216

Phone

(954) 536-3118

NPI assigned

Dec 19, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Norda HernandezNPI 1336379445

Title

Director

Phone

(954) 536-3118

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Norda Hernandez, PSY.D.

  • Psychologist
  • Weston, FL
  • NPI 1336379445

  FL, Psychologist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1144765686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N COMMERCE PKWY",
            "address_2": "SUITE 210",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263216",
            "telephone_number": "954-536-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N COMMERCE PKWY",
            "address_2": "SUITE 210",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263216",
            "telephone_number": "954-536-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACIOUS MIND P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "NORDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-536-3118",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Andreina Gonzalez
• Joshua D Gordon
• Meeta Govindarajan, M.D.
• Charles Andrew Gowans, R.PH.
• Mike Wood Gracia, APRN
• Barbara Icylin Graham-Samuels, RN
• Amanda Raveli Grant, APRN-BC
• Avalon Karen Grantham, APRN, FNP-BC
• Bertram Grapin
• Greater Florida Anesthesiologists, LLC

• All providers in Weston, FL
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.