Provider Demographics
NPI:1285663179
Name:SCUNZIANO-SINGH, MARIA GRACE (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:GRACE
Last Name:SCUNZIANO-SINGH
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 1:4248 LAKE IN THE WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34607-2501
Mailing Address - Country:US
Mailing Address - Phone:352-254-8090
Mailing Address - Fax:352-616-0944
Practice Address - Street 1:4270 LAKE IN THE WOODS DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34607-2501
Practice Address - Country:US
Practice Address - Phone:352-597-7249
Practice Address - Fax:352-597-9523
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253872500Medicaid
FL006641300Medicaid
FL31544OtherBCBS OF FLORIDA
FL110222498OtherRR MCR ATTACHED TO GROUP CH7269
FL31544OtherBCBS OF FLORIDA
G64802Medicare UPIN
FL110222498OtherRR MCR ATTACHED TO GROUP CH7269
FL31544UMedicare PIN