Active NPI
Gracemdconnect
- Pediatrics Physician
- Windermere, FL
National Provider Identifier
1265934087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME122569
- Legal business name
- GRACEMDCONNECT
- Doing business as
- Gracemdconnect
- Practice address
- 11934 Angle Pond Ave
Windermere, FL 34786-6526 - Phone
- (718) 344-7062
- NPI assigned
- Mar 7, 2018
- Organization subpart
- Yes
- Parent organization
- GRACE MED PA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Deepa Sukumar, MD
- Title
- President
- Phone
- (718) 344-7062
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME122569 | FL | Primary |
Addresses
Primary practice location
11934 Angle Pond Ave
Windermere, FL 34786-6526
Mailing address
11934 Angle Pond Ave
Windermere, FL 34786-6526
Other names 1
- GRACEMDCONNECT
National Provider Directory
National Provider Directory- Part of
- Gracemdconnect
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pediatrics Physician
- Orlando, FL
- NPI 1922080043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1520380800000",
"number": "1265934087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11934 ANGLE POND AVE",
"city": "WINDERMERE",
"state": "FL",
"postal_code": "347866526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11934 ANGLE POND AVE",
"city": "WINDERMERE",
"state": "FL",
"postal_code": "347866526",
"telephone_number": "718-344-7062"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRACEMDCONNECT",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GRACE MED PA",
"enumeration_date": "2018-03-07",
"last_updated": "2018-03-07",
"status": "A",
"authorized_official_last_name": "SUKUMAR",
"authorized_official_first_name": "DEEPA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-344-7062",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "FL",
"license": "ME122569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "GRACEMDCONNECT",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Windermere, FL
- Jennifer Gonzalez, O.D.
- Rafael Alberto Gonzalez, LMHC (MH 16065)
- Sorimar Gonzalez
- Good One Services LLC
- Magdalena S Gordon, RIMH
- Nycole Larai Graham, RN
- Carol Theresa Grande, OTR/L
- Grayt Healthcare, Inc. (Amada Senior Care Orlando)
- Amy Elizabeth Greene, M.A., LMHC
- Cynthia Barbara Guerrero Gentile, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.