Provider Demographics
NPI:1982600284
Name:BRAZIL, MARIA J (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:J
Last Name:BRAZIL
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 1:7868 NW 100TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-7340
Mailing Address - Country:US
Mailing Address - Phone:417-829-4620
Mailing Address - Fax:
Practice Address - Street 1:1235 E CHEROKEE ST
Practice Address - Street 2:ANESTHESIA
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2203
Practice Address - Country:US
Practice Address - Phone:417-820-6863
Practice Address - Fax:417-820-6868
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036089061207L00000X
MOR8E40207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR177416001Medicaid
MO209047117Medicaid
431560263OtherTRICARE WEST
MOP00716888OtherRAILROAD MEDICARE
MO132680073Medicare PIN
MOA29283Medicare UPIN
MO209047117Medicaid