Basic Information
| Provider Information | |||||||||
| NPI: | 1285663179 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCUNZIANO-SINGH | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | GRACE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4248 LAKE IN THE WOODS DR | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346072501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522548090 | ||||||||
| FaxNumber: | 3526160944 | ||||||||
| Practice Location | |||||||||
| Address1: | 4270 LAKE IN THE WOODS DR | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346072501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525977249 | ||||||||
| FaxNumber: | 3525979523 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2006 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME70767 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 253872500 | 05 | FL | MEDICAID | 006641300 | 05 | FL | MEDICAID | 31544 | 01 | FL | BCBS OF FLORIDA | OTHER | 110222498 | 01 | FL | RR MCR ATTACHED TO GROUP CH7269 | OTHER |