MEDICARE: MARIA J BRAZIL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	036089061	IL
2	207L00000X	Anesthesiology Physician	R8E40	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00716888	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	431560263	OTHER	TRICARE WEST

General Provider Information

NPI Number	:	1982600284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA J BRAZIL MD

Provider Business Mailing Address
First Line	:	7868 NW 100TH ST
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34482-7340
Country	:	US
Telephone Number	:	417-829-4620
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 E CHEROKEE ST
Second Line	:	ANESTHESIA
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-2203
Country	:	US
Telephone Number	:	417-820-6863
Fax Number	:	417-820-6868

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	02/22/2023

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Directions to “ MARIA J BRAZIL MD” Practice Location

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