Organization
SUMMIT PRIMARY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACEMARIE ROSARIO WALLS PA-C (OWNER)
(321) 496-5717
Entity
Organization
Contact information
Practice address
13564 VILLAGE PARK DR UNIT O-355, ORLANDO, FL 32837-7760
(407) 974-4056
(407) 550-7844
Mailing address
13564 VILLAGE PARK DR UNIT O-355, ORLANDO, FL 32837-7760
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
10/25/2025
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