Individual provider Active NPI

Marilucy Grau, ARNP

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1689096216
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9193606 Issued in FL
Practice address
1502 Village Oak LN
Kissimmee, FL 34746-6592
Phone
(407) 205-3588
Fax
(407) 978-6757
NPI assigned
Jan 16, 2014
Last updated
Nov 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9193606 FL Primary

Addresses

Primary practice location

1502 Village Oak LN
Kissimmee, FL 34746-6592

Mailing address

121 S Orange Ave Ste 940
Orlando, FL 32801-3234
Phone (407) 658-9687

Other identifiers 1

IdentifierTypeStateIssuer
F0114050OtherFLAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION PROGRAM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9193606FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Idelis Fedeslinda Arias de la Torre PastSince Jun 1, 2021 Accepting new patients
Orlando Family Physicians, LLC PastSince Jan 5, 2025 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1689096216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S ORANGE AVE STE 940",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013234",
            "telephone_number": "407-658-9687",
            "fax_number": "407-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 VILLAGE OAK LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347466592",
            "telephone_number": "407-205-3588",
            "fax_number": "407-978-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAU",
        "first_name": "MARILUCY",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9193606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION PROGRAM",
            "identifier": "F0114050",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.