Healthcare Provider Details

I. General information

NPI: 1376857839
Provider Name (Legal Business Name): GRACE-ANN SUTHERLAND ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 DARDEN CENTER DR
ORLANDO FL
32837-4032
US

IV. Provider business mailing address

1000 DARDEN CENTER DR
ORLANDO FL
32837-4032
US

V. Phone/Fax

Practice location:
  • Phone: 407-245-4921
  • Fax:
Mailing address:
  • Phone: 407-245-4921
  • Fax: 407-245-4924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3314612
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3314612
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: