MARCIO LICURGO DE AZEVEDO APRN
NPI 1861266074
Nurse Practitioner - Psychiatric/Mental Health in Ocoee, FL

Q: What is Marcio Licurgo De Azevedo's NPI number?

The NPI number for Marcio Licurgo De Azevedo is 1861266074. It was assigned to this individual provider in the NPPES registry on November 8, 2023.

Q: What is Marcio Licurgo De Azevedo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since November 08, 2023PECOS EnrolledAccepts Medicare Assignment

2910 MAGUIRE RD STE 2002, OCOEE, FL 34761(239) 690-6906 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 13, 2024, Nov 8, 2023 (2 updates tracked since 2023).

On this page

About Marcio Licurgo De Azevedo Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARCIO LICURGO DE AZEVEDO APRN (NPI 1861266074) is an individual psychiatric/mental health provider in Ocoee, Florida, licensed in Florida (11029589) and active in the NPI registry since November 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1861266074

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMARCIO LICURGO DE AZEVEDOCredential: APRN

Location Address2910 MAGUIRE RD STE 2002Ocoee, FL 34761-4742

Mailing Address15024 Chapter WayWinter Garden, FL 34787-1764 · (901) 317-9198

Phone(239) 690-6906

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateNovember 8, 2023

Last NPPES UpdateJune 13, 20242 updates tracked since enumeration

NPPES CertifiedJune 13, 2024

✔ NPI 1861266074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in FL · 11029589

2910 MAGUIRE RD STE 2002, Ocoee, FL 34761

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marcio Licurgo De Azevedo Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153771993

PECOS Enrollment IDI20231220001796

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Marcio Licurgo De Azevedo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mindful Behavioral Healthcare, LLC

18 mi

Community/Behavioral Health

717 E OAK ST
Kissimmee, FL 34744

Reassigned Medicare billing, Florida enrollment
22 clinicians in this Medicare group

NPI 1477744548 (407) 846-0533

Lehigh Acres Bg Opco LLC

133 mi

Assisted Living Facility

1251 BUSINESS WAY
Lehigh Acres, FL 33936

Reassigned Medicare billing, Florida enrollment
Medicare enrollment name: Dna Comprehensive Therapy Services LLC
618 clinicians in this Medicare group

NPI 1760939813 (239) 368-2500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34761 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA SARAH GUERRERO PMHNP

Nurse Practitioner (Psychiatric/Mental Health)