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SUMMIT PRIMARY CARE PLLC
NPI 1548143274
Physician Assistant - Medical in Orlando, FL

Active since July 29, 2025CLIA 10D2342831 · Waiver
13564 VILLAGE PARK DR UNIT O-355, ORLANDO, FL 32837(407) 974-4056(407) 550-7844 Get Directions Write a Review

NPPES record last updated: October 25, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Summit Primary Care Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT PRIMARY CARE PLLC (NPI 1548143274) is a healthcare organization registered as a medical in Orlando, Florida and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through April 27, 2028 and lists Gracemarie Rosario Walls, Owner, as its authorized official.

NPPES Registry Identity

NPI1548143274
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameSUMMIT PRIMARY CARE PLLC
Location Address13564 VILLAGE PARK DR UNIT O-355Orlando, FL 32837-7760
Mailing Address13564 Village Park Dr Unit O-355Orlando, FL 32837-7760
Phone(407) 974-4056
Fax(407) 550-7844
Organization SubpartNo
Authorized OfficialGracemarie Rosario WallsOwner · (321) 496-5717
Enumeration DateJuly 29, 2025
Last NPPES UpdateOctober 25, 2025
NPPES CertifiedOctober 25, 2025
✔ NPI 1548143274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
13564 VILLAGE PARK DR UNIT O-355, Orlando, FL 32837
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2342831

Summit Primary Care PLLC · Orlando, FL
Active · expires Apr 27, 2028
CLIA Number10D2342831
Laboratory TypePhysician Office
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorGracemarie R. Walls
Laboratory Phone(407) 974-4056
Laboratory LocationSummit Primary Care PLLC13564 Village Park Dr Unit 355, Orlando, FL 32837
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRACEMARIE ROSARIO WALLS PA-C
Physician Assistant
13564 VILLAGE PARK DR UNIT O-355
ORLANDO, FL 32837
Orange County (407) 974-4056

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summit Primary Care PLLC's NPI number?

The NPI number for Summit Primary Care PLLC is 1548143274. It was assigned to this organization in the NPPES registry on July 29, 2025.

Where is Summit Primary Care PLLC located?

Summit Primary Care PLLC is located at 13564 Village Park Dr Unit O-355, Orlando, FL 32837. The listed phone number is (407) 974-4056.

What is Summit Primary Care PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Does Summit Primary Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2342831) is associated with this NPI, valid through April 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Summit Primary Care PLLC was last updated on October 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.