Provider Demographics
NPI:1417905753
Name:ASEVEDO, MARIA REGINA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:REGINA
Last Name:ASEVEDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 LEE RD STE 165
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2127
Mailing Address - Country:US
Mailing Address - Phone:407-975-0406
Mailing Address - Fax:407-975-0407
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:FLORIDA HOSPITAL OB SPECIALISTS
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-975-0406
Practice Address - Fax:407-975-0407
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2016-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-9067207V00000X
PAMD423486207V00000X
FLME109743207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010147130OtherREGENCE BLUE SHIELD
PA1019641110001Medicaid
7977586OtherAETNA
11437585OtherCAQH
ID806872900Medicaid
ID267222OtherALTIUS
PA109730OtherGEISINGER
PA200665392OtherAMERIHEALTH MERCY
PA001975906OtherHIGHMARK BS
ID70391OtherBLUE CROSS ID
PA822307OtherFIRST PRIORITY HEALTH
949545OtherFIRST HEALTH
PA50072156OtherKEYSTONE CAPITAL BC
PA114664WDBMedicare PIN
949545OtherFIRST HEALTH
IDG27788Medicare UPIN