Individual provider Active NPI

Alyssa Jane Grundon

  • Obstetrics & Gynecology Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1154963809
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
APRN11015726 Issued in FL
Practice address
1705 Kuhl Ave
Orlando, FL 32806-2024
Phone
(321) 841-8855
Fax
(321) 841-8977
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X APRN11015726 FL Primary
Registered Nurse 163W00000X RN9408793 FL

Addresses

Primary practice location

1705 Kuhl Ave
Orlando, FL 32806-2024

Mailing address

1705 Kuhl Ave
Orlando, FL 32806-2024
Phone (321) 841-8855

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
I20220421000249 FL Practitioner - Nurse Practitioner 0840687828 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9408793FLMDRegistered Nurse
APRN11015726FLMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2022 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Apr 1, 2022 Accepting new patients

Locations

1001 E Osceola Pkwy
Ste 230
Kissimmee, FL 34744
Phone (321) 842-4810

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

1502 Lucerne Ter
Orlando, FL 32806
Phone (321) 841-2262

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: agrundon25033@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1154963809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 KUHL AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062024",
            "telephone_number": "321-841-8855",
            "fax_number": "321-841-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 KUHL AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062024",
            "telephone_number": "321-841-8855",
            "fax_number": "321-841-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNDON",
        "first_name": "ALYSSA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "APRN11015726",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9408793",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.