Individual provider Active NPI

Marissa Celine Maldonado, MD

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1356081889
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME171482 Issued in FL
Practice address
2730 N McMullen Booth Rd Ste 201
Clearwater, FL 33761-3302
Phone
(727) 725-5224
Fax
(727) 799-2183
NPI assigned
Mar 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME171482 FL Primary

Addresses

Primary practice location

2730 N McMullen Booth Rd Ste 201
Clearwater, FL 33761-3302

Mailing address

2730 N McMullen Booth Rd Ste 201
Clearwater, FL 33761-3302
Phone (727) 725-5224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250919004282 FL Practitioner - Family Practice 9638550973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Management of Florida IncGroup PAC ID 3971678558, 158 clinicians

Practice addresses (Care Compare)

1259 S Pinellas Ave
Tarpon Springs, FL 34689-3719
Phone (727) 938-1908

Hospital & facility affiliations

  • Adventhealth North Pinellas Hospital, Tarpon Springs, FL, CCN 100055
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc Family Medicine CurrentSince Sep 7, 2025 Accepting new patients

Locations

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

1259 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 938-1908

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1356081889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 N MCMULLEN BOOTH RD STE 201",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613302",
            "telephone_number": "727-725-5224",
            "fax_number": "727-799-2183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 N MCMULLEN BOOTH RD STE 201",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613302",
            "telephone_number": "727-725-5224",
            "fax_number": "727-799-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "MARISSA",
        "middle_name": "CELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME171482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.