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ALINA COMMUNITY CENTER AT MOUNT DORA LLC
NPI 1811550346
Family Medicine in Mount Dora, FL

Active since April 19, 2019CLIA 10D2181840 · Waiver
4601 N HIGHWAY 19A, MOUNT DORA, FL 32757(352) 602-7924(352) 602-4952 Get Directions Write a Review

NPPES record last updated: January 2, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 2, 2025, May 21, 2020, Apr 19, 2019 (3 updates tracked since 2019).

About Alina Community Center At Mount Dora Llc NPPES

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

ALINA COMMUNITY CENTER AT MOUNT DORA LLC (NPI 1811550346) is a healthcare organization registered as a family medicine in Mount Dora, Florida and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through April 12, 2028 and lists Gravil Joseph, Mgr, as its authorized official.

NPPES Registry Identity

NPI1811550346
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameALINA COMMUNITY CENTER AT MOUNT DORA LLC
Location Address4601 N HIGHWAY 19AMount Dora, FL 32757-2039
Mailing Address4601 N Highway 19aMount Dora, FL 32757-2039 · (352) 602-7924 · Fax (352) 602-4952
Phone(352) 602-7924
Fax(352) 602-4952
Organization SubpartNo
Authorized OfficialGravil JosephMgr · (352) 602-7924
Enumeration DateApril 19, 2019
Last NPPES UpdateJanuary 2, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 2, 2025
✔ NPI 1811550346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4601 N HIGHWAY 19A, Mount Dora, FL 32757
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alina Community Center At Mount Dora Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Alina Community Center At Mount Dora LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Widdler Deshommes, MD
General Practice
NPI 1376172015
4601 N HIGHWAY 19A
Mount Dora, FL 32757
(352) 290-8718
✔ PECOSSame address
Scott Menard, MD
General Practice
NPI 1417579244
4601 NORTH, FL-19
Mount Dora, FL 32757
(239) 245-1698
✔ PECOS✔ Accepts Medicare4.0 mi
Darmeta Bradley, APRN
Nurse Practitioner
NPI 1750851044
1949 BEACON BAY CT
Apopka, FL 32712
(407) 446-5004
✔ PECOS13 mi
Khaled Ibrahim, M.D.
General Practice
NPI 1497108393
264A PALM COAST PKWY NE
Palm Coast, FL 32137
(386) 446-5505
✔ PECOS✔ Accepts Medicare58 mi
Joel Pelissier, M.D.
Hospitalist
NPI 1730454323
350 7TH ST N
Naples, FL 34102
(239) 624-3997
✔ PECOS✔ Accepts Medicare184 mi
Philippe Carrie, M.D.
Psychiatry
NPI 1639431083
4800 N STATE ROAD 7
Lauderdale Lakes, FL 33319
(954) 892-3318
✔ PECOS✔ Accepts Medicare204 mi
Gravil Joseph, APRN
Nurse Practitioner
NPI 1164960720
10515 SW 24TH ST
Miramar, FL 33025
(305) 767-0887
✔ PECOS✔ Accepts Medicare213 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 10D2181840

Alina Community Center At Mount Dora LLC · Mount Dora, FL
Active · expires Apr 12, 2028
CLIA Number10D2181840
Laboratory TypePhysician Office
Certificate Effective DateApril 13, 2026
Certificate Expiration DateApril 12, 2028
Laboratory DirectorGravil Joseph
Laboratory Phone(352) 602-7924
Laboratory LocationAlina Community Center At Mount Dora LLC4601 N Hwy 19A, Mount Dora, FL 32757
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Alina Community Center At Mount Dora LLC's NPI number?

The NPI number for Alina Community Center At Mount Dora LLC is 1811550346. It was assigned to this organization in the NPPES registry on April 19, 2019.

Where is Alina Community Center At Mount Dora LLC located?

Alina Community Center At Mount Dora LLC is located at 4601 N Highway 19A, Mount Dora, FL 32757. The listed phone number is (352) 602-7924.

What is Alina Community Center At Mount Dora LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Alina Community Center At Mount Dora LLC enrolled in Medicare?

Yes. Alina Community Center At Mount Dora LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Alina Community Center At Mount Dora LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 4 Medicare specialties reassign their Medicare billing to Alina Community Center At Mount Dora LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are General Practice (3), Nurse Practitioner (2) and Hospitalist (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Alina Community Center At Mount Dora LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2181840) is associated with this NPI, valid through April 12, 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 Alina Community Center At Mount Dora LLC was last updated on January 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.