Alina Community Center at Mount Dora LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ALINA COMMUNITY CENTER AT MOUNT DORA LLC

Practice address

4601 N Highway 19a
Mount Dora, FL 32757-2039

Phone

(352) 602-7924

Fax

(352) 602-4952

NPI assigned

Apr 19, 2019

Organization subpart

No

Name

Gravil Joseph, APRNNPI 1164960720

Title

MGR

Phone

(352) 602-7924

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Alina Community Center at Mount Dora LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Dora, FL
  • NPI 1841801842

  O20200603001057

  Same enrollment

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

• Gravil Joseph, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Miramar, FL
  • NPI 1164960720

  FL, Multi-Specialty

  Medicare reassignment NPD Authorized official
• Darmeta Rashane Bradley, APRN

  • Family Health Clinical Nurse Specialist
  • Apopka, FL
  • NPI 1750851044

  FL

  Medicare reassignment NPD
• Philippe Jacques Carrie, M.D.

  • Psychiatry Physician
  • Lauderdale Lakes, FL
  • NPI 1639431083

  FL

  Medicare reassignment NPD
• Widdler Deshommes, MD

  • General Practice Physician
  • Mount Dora, FL
  • NPI 1376172015

  FL

  Medicare reassignment NPD
• Khaled Ibrahim, M.D.

  • General Practice Physician
  • Palm Coast, FL
  • NPI 1497108393

  FL

  Medicare reassignment NPD
• Scott Menard, MD

  • Adult Medicine Physician
  • Mount Dora, FL
  • NPI 1417579244

  FL

  Medicare reassignment NPD
• Joel Charles Pelissier, M.D.

  • Internal Medicine Physician
  • Naples, FL
  • NPI 1730454323

  FL, Internal Medicine

  Medicare reassignment NPD
• Eden Barbara Belgarde

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Dora, FL
  • NPI 1851042006
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in FL

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 2, 2025.

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1811550346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 N HIGHWAY 19A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572039",
            "telephone_number": "352-602-7924",
            "fax_number": "352-602-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 N HIGHWAY 19A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572039",
            "telephone_number": "352-602-7924",
            "fax_number": "352-602-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALINA COMMUNITY CENTER AT MOUNT DORA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-19",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "GRAVIL",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "352-602-7924",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hana Nasim Ahmed, MD
• Sara Christine Aksouh
• Albertsons LLC
• Sabine Alerte
• Munsif Ali, M.D
• Alina Community Center at Mount Dora LLC
• All About Hearing LLC
• Julie L Allen, LMT
• Patricia Allen
• Chantal Jenema Alleyne-Simmons

• All providers in Mount Dora, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.