Healthcare Provider Details

I. General information

NPI: 1891609319
Provider Name (Legal Business Name): ELITE RHEUMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 ORLANDO CENTRAL PKWY
ORLANDO FL
32809-5732
US

IV. Provider business mailing address

14194 LANIKAI BEACH DR
ORLANDO FL
32827-8017
US

V. Phone/Fax

Practice location:
  • Phone: 407-888-5980
  • Fax: 407-888-2492
Mailing address:
  • Phone: 407-888-5980
  • Fax: 407-888-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUMALATHA NANDIKONDA
Title or Position: OWNER
Credential: MD
Phone: 269-267-3569