Marcio Licurgo de Azevedo, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11029589 Issued in FL

Practice address

2910 Maguire Rd Ste 2002
Ocoee, FL 34761-4742

Phone

(239) 690-6906

NPI assigned

Nov 8, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.43 of 100Reported as group

Quality

74.02

Promoting interoperability

100

Improvement activities

40

Cost

77.26

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marcio.licurgo.de.azevedo.1@13142.direct.athenahealth.com

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.

• Dna Comprehensive Therapy Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757
  Medicare reassignment Care Compare group NPD
• Mindful Behavioral Healthcare, LLC

  • Community/Behavioral Health Agency
  • Kissimmee, FL
  • NPI 1477744548
  Medicare reassignment NPD
• Bonita Springs Retirement Village, Inc.

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD
• Mindful Integrated Medicine LLC

  • General Practice Physician
  • Kissimmee, FL
  • NPI 1831544832
  NPD (past)

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1861266074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15024 CHAPTER WAY",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347871764",
            "telephone_number": "901-317-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 MAGUIRE RD STE 2002",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614742",
            "telephone_number": "239-690-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICURGO DE AZEVEDO",
        "first_name": "MARCIO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11029589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Lerma Murillo
• Flana Rose Levando, OD
• Kevin Lewin, RPH
• Arielle K Lewkowitz
• Maha Lamiyaa Lhaini
• Jeffrey Scott Lincoln, DC
• Nicole Paige Lingle, CRNA
• Vanessa Lisojo, REGISTERED INTERN
• Little Bites Feeding Therapy
• Danielle R Little, MD

• Psychiatric/Mental Health Nurse Practitioner in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.