Provider Directory As of 3/7/2025
High Quality Care. Unmatched Access. MaxHealth along with some of the most trusted providers in Florida have teamed up to deliver Medicare-eligible patients with personalized health care. Our diverse team of primary care providers deliver value-based care to ensure patients receive coordinated care focused on prevention, wellness, and convenience. We treat patients like family, making it easy to access care from more than 48 locations throughout the state. How to use this directory: 1) Visit the Table of Contents on the next page. Click on any region, county, or facility to jump to that page. 2) Locate Provider Participation ID’s and panel statuses under each provider’s name. 3) Once your confirm the provider accepts your client’s plan, you can assign your client to the provider through their insurance. 4) After assigning your client to the provider through their insurance, fill out the registration form on mymaxdoc.com/partnerships/brokers-agents. Our team will reach out to your client to schedule their appointment and/or confirm their updated insurance information.
Provider Directory | MaxHealth | www.mymaxdoc.com 3 Pasco County MaxHealth - Wesley Chapel | Windguard Cir .....................................................................................................................5 MaxHealth - Zephyrhills | Gall Blvd..........................................................................................................................................6 MaxHealth - Port Richey | Ridge Rd | 2 ...................................................................................................................................7 MaxHealth - Holiday | US-19 Alt ................................................................................................................................................8 MaxHealth - Holiday | 1812 US-19.............................................................................................................................................9 Pinellas County MaxHealth - St Petersburg | 7th St S ..................................................................................................................................... 10 MaxHealth - Largo | E Bay Dr.................................................................................................................................................... 11 MaxHealth - Dunedin | Main St ............................................................................................................................................... 12 MaxHealth - Pinellas Park | 49th St N ................................................................................................................................. 13 MaxHealth - Clearwater | S Fort Harrison Ave ............................................................................................................... 14 MaxHealth - Clearwater | McMullen Booth ..................................................................................................................... 15 MaxHealth - Seminole | Park Blvd ......................................................................................................................................... 16 Hillsborough County MaxHealth - Tampa | E Fletcher Ave ................................................................................................................................... 17 MaxHealth - Tampa | N Dale Mabry Hwy........................................................................................................................... 18 MaxHealth - Tampa | N Habana Ave ................................................................................................................................... 19 MaxHealth - Tampa | Webb Rd .............................................................................................................................................. 20-21 MaxHealth - Brandon | S Kings Ave (relocated to Brandon Lithia effective 8/26/2024) ...................... 22 MaxHealth - Brandon | Lithia Pinecrest Rd....................................................................................................................... 23 MaxHealth - Plant City | Thonotosassa Rd ....................................................................................................................... 24 MaxHealth - Riverview | US-301 S ......................................................................................................................................... 25 Tampa Bay Table Of Contents Polk County MaxHealth - Lakeland | Griffin Rd ......................................................................................................................................... 26 MaxHealth - Lake Wales | S 11th St ...................................................................................................................................... 27 MaxHealth - Davenport | North Blvd W ............................................................................................................................. 28 MaxHealth - Dundee | HWY 27 ............................................................................................................................................... 29 Marion County MaxHealth - Summerfield | SE 174th Place Rd .............................................................................................................. 30 Sumter County MaxHealth - Wildwood | Seven Mile Dr ............................................................................................................................. 31 Osceola County MaxHealth - Celebration | Celebration Blvd .................................................................................................................... 32 DeSoto County MaxHealth - Arcadia | Nursing Home Drive .................................................................................................................... 33 Hardee County MaxHealth - Wauchula | S 6th Ave ....................................................................................................................................... 34 Central Florida For easy navigation, click on the region, county, or clinic to jump to that page.
Provider Directory | MaxHealth | www.mymaxdoc.com 4 Manatee County MaxHealth - Bradenton | Cortez Rd W | 1 ..........................................................................................................................35-36 MaxHealth - Bradenton | Cortez Rd W | 2 ..........................................................................................................................37 MaxHealth - Bradenton | 2nd St E...........................................................................................................................................38 MaxHealth - Bradenton | 701 Manatee Ave W ................................................................................................................39 MaxHealth - Bradenton | 5225 Manatee Ave W..............................................................................................................40 MaxHealth - Bradenton | 7431 Manatee Ave W..............................................................................................................41 MaxHealth - Bradenton | 53rd Ave E ................................................................................................................................... 42 MaxHealth - Ellenton | US-301 N............................................................................................................................................ 43 MaxHealth - Lakewood Ranch | Palmbrush Trl............................................................................................................... 44 MaxHealth - Palmetto | 4th Ave W ........................................................................................................................................ 45 Sarasota County MaxHealth - Venice | Jacaranda Blvd ................................................................................................................................ 46 MaxHealth - North Port | Aidan Ln ............................................................................................................................... ........47 MaxHealth - Sarasota | Osprey Ave .............................................................................................................................. ........48 MaxHealth - Sarasota | Bee Ridge Rd...................................................................................................................................49-50 MaxHealth - Sarasota | University Parkway.................................................................................................................51 Lee County MaxHealth - Cape Coral | SE 16th Pl ................................................................................................................................... 52 MaxHealth - North Fort Myers | Pine Island Rd .............................................................................................................. 53 Collier County MaxHealth - North Naples | Vanderbilt Beach Rd ....................................................................................................... 54 MaxHealth - Naples | Goodlette-Frank Rd N .................................................................................................................. 55 Okeechobee County MaxHealth - Okeechobee | SE Park St................................................................................................................................. 56 Palm Beach County MaxHealth - West Palm Beach | N Congress Ave .......................................................................................................... 57 Broward County MaxHealth - Fort Lauderdale | W Commercial Blvd..................................................................................................... 58 Miami-Dade County MaxHealth - Hialeah | W 49th St ........................................................................................................................................... 59 MaxHealth - Hialeah | W 76th St............................................................................................................................................. 60 MaxHealth - Miami | Sunset Dr ............................................................................................................................................... 61 Gulf Coast South Florida Table Of Contents
TAMPA BAY | PASCO COUNTY 5 2607 Windguard Circle, Suite 102 Wesley Chapel, FL 33544 P: (813) 907-6767 | F: (813) 907-1991 MaxHealth - Wesley Chapel | Windguard Cir Provider Directory | MaxHealth | www.mymaxdoc.com Mary Montsko, MD Health Plan Provider ID Aetna 7561870 BCBS (Florida Blue) 91691 CarePlus Health Plans 1095554 Cigna QMP000005768237 Devoted Health LX27GW-AF Freedom Health P1049835 Health Plan Provider ID Humana 128509 Medicare Florida QH314 Optimum Healthcare P982327 Simply Healthcare 16896611 Ultimate Health Plans 200000044867 United Healthcare 002716012 WellCare 3528692 Tamara Martin, MSN, APRN, FNP
PASCO COUNTY | TAMPA BAY 6 6719 Gall Boulevard, Suite 107 Zephyrhills, FL 33542 P: (813) 377-1881 | F: (813) 377-1882 MaxHealth - Zephyrhills | Gall Blvd Provider Directory | MaxHealth | www.mymaxdoc.com Bernardo Malaga, MD Health Plan Provider ID Health Plan Provider ID Humana 128570 Medicare Florida R1483 Optimum Healthcare P00021698 Simply Healthcare 20315173 Ultimate Health Plans 200000049064 United Healthcare 003053529 WellCare 3576954 Tamara Martin, MSN, APRN, FNP Aetna 9726309 BCBS (Florida Blue) XKR3E CarePlus Health Plans 1227175 Cigna QMP0000063476 Devoted Health LX27GY-AE Freedom Health P00022746
6551 Ridge Rd, Suite 2 Port Richey, FL 34668 P: (727) 846-0666 | F: (727) 849-1474 MaxHealth - Port Richey | Ridge Rd | 2 Yogesh Ranpariya, MD Health Plan Provider ID Aetna - Closed 7602836 BCBS (Florida Blue) Non-Participating CarePlus Health Plans 1067330 - Closed Cigna Non-Participating Devoted Health LX3374-AA - Closed Freedom Health P03619 Health Plan Provider ID Humana 128773 Medicare Florida PP154 - Closed Optimum Healthcare P200909 Simply Healthcare 14669337 - Closed Ultimate Health Plans 200000038534 - Closed United Healthcare 002685356 - Closed WellCare 363036 - Closed Brittany Davis, APRN TAMPA BAY | PASCO COUNTY 7 Provider Directory | MaxHealth | www.mymaxdoc.com
1162 US-19 Alt North Holiday, FL 34691 P: (727) 937-3010 | F: (727) 938-7435 MaxHealth - Holiday | US-19 Alt Rajesh Patel, MD Health Plan Provider ID Aetna 5833266 - Closed BCBS (Florida Blue) 27735 CarePlus Health Plans 1003118 Cigna QMP000004805867 Devoted Health LX35HS-AA Freedom Health P103487A Health Plan Provider ID Humana 128602 Medicare Florida OJ544 Optimum Healthcare P2001408 Simply Healthcare Non-Participating Ultimate Health Plans Non-Participating United Healthcare 00040077009 WellCare 3111441 PASCO COUNTY | TAMPA BAY 8 Provider Directory | MaxHealth | www.mymaxdoc.com
9 1812 US-19 North Holiday, FL 34691 P: (727) 942-3355 | F: (877) 902-4052 Deepa Subramanian, MD Health Plan Provider ID Aetna 9272672 - Closed BCBS (Florida Blue) 146XP - Closed CarePlus Health Plans Non-participating Cigna Non-participating Devoted Health Non-participating Freedom Health P117983 - Closed Health Plan Provider ID Humana 128877 - Open Medicare Florida QW162 - Closed Optimum Healthcare 1588744429 Simply Healthcare Non-Participating Ultimate Health Plans Non-Participating United Healthcare 002971527 - Closed WellCare Non-Participating Laura McGovern, MD Health Plan Provider ID Aetna 9049949 BCBS (Florida Blue) NW615 CarePlus Health Plans Non-Participating Cigna Non-Participating Devoted Health Non-Participating Freedom Health P00077371 Health Plan Provider ID Humana 128877 Medicare Florida SM210 Optimum Healthcare P00057599 Simply Healthcare Non-Participating Ultimate Health Plans Non-Participating United Healthcare 003556488 WellCare Non-Participating MaxHealth - Holiday | 1812 US-19 TAMPA BAY | PASCO COUNTY 9 Provider Directory | MaxHealth | www.mymaxdoc.com
601 7th Street South, Suite 530 Saint Petersburg, FL 33701 P: (727) 322-4228 | F: (727) 322-4658 MaxHealth - St Petersburg | 7th St S Monica Clemente-Ortiz, MD Health Plan Provider ID Aetna 4887232 - Closed BCBS (Florida Blue) QJI1W - Closed CarePlus Health Plans 1137472 - Closed Cigna QMP000004925087 - Closed Devoted Health LX2R92-AA - Closed Freedom Health P1032362E - Closed Health Plan Provider ID Humana 126526 - Closed Medicare Florida OC525 - Closed Optimum Healthcare P968715E - Closed Simply Healthcare N/A Ultimate Health Plans 200000040394 - Closed United Healthcare 00010098990 - Closed WellCare 2178409 - Closed PINELLAS COUNTY | TAMPA BAY 10 Provider Directory | MaxHealth | www.mymaxdoc.com
3800 East Bay Drive Largo, FL 33771 P: (727) 539-0505 | F: (727) 538-0067 MaxHealth - Largo | E Bay Dr Donald Collins, DO Melissa Swek, APRN Alessandra Cantone-Ferrill, MD Health Plan Provider ID Aetna 9487267 BCBS (Florida Blue) 53262_x000D CarePlus Health Plans 1181098 - Closed Cigna QMP000004660764 Devoted Health LX22W6-AB - Closed Freedom Health P00001256A Health Plan Provider ID Humana 125281 Medicare Florida AM183Y Optimum Healthcare P00078687A Simply Healthcare 06403952 - Closed Ultimate Health Plans 200000018028 - Closed United Healthcare 00010069269 WellCare 1583520 Health Plan Provider ID Aetna 4155096 BCBS (Florida Blue) CSZXP CarePlus Health Plans 1202415 Cigna QMP000004435598 Devoted Health LX22W6-AE Freedom Health P0004122 Health Plan Provider ID Humana 125281 Medicare Florida QC225 Optimum Healthcare P00047033 Simply Healthcare 16912873 - Closed Ultimate Health Plans 200000036541 UnitedHealthcare 00549814 WellCare 3445714 TAMPA BAY | PINELLAS COUNTY 11 Provider Directory | MaxHealth | www.mymaxdoc.com
2128 Main Street Dunedin, FL 34698 P: (727) 736-7733 | F: (727) 736-7740 MaxHealth - Dunedin | Main St Beverly Encarnacion, MD Health Plan Provider ID Aetna 5615750 BCBS (Florida Blue) 43411 CarePlus Health Plans 1067939 Cigna QMP000003466432 Devoted Health LXFHUH-AA Freedom Health P02810A Health Plan Provider ID Humana 128590 Medicare Florida OI705 Optimum Healthcare P511277A Simply Healthcare 1209912 - Closed Ultimate Health Plans 200000027289 United Healthcare 00040075665 WellCare 240216 PINELLAS COUNTY | TAMPA BAY 12 Provider Directory | MaxHealth | www.mymaxdoc.com Renee Fondren, APRN
6637 49th Street North Pinellas Park, FL 33781 P: (727) 528-8000 | F: (727) 528-1400 MaxHealth - Pinellas Park | 49th St N TAMPA BAY | PINELLAS COUNTY 13 Provider Directory | MaxHealth | www.mymaxdoc.com Jeannette Figueroa-Gordian, MD Health Plan Provider ID Aetna 4979454 BCBS (Florida Blue) 14TJ9 - Closed CarePlus Health Plans 1186798 - Closed Cigna QMP000004700041 Devoted Health LXES94-AF Freedom Health P1009824 Health Plan Provider ID Humana Center 128508 Medicare Florida 10884121 Optimum Healthcare P953381 Simply Healthcare 2425630 -Closed Ultimate Health Plans 200000021945 United Healthcare 003347554 - Closed WellCare 2353717 - Closed
1100 S Fort Harrison Ave Clearwater, FL 33756 P: (727) 223-3650 | F: (727) 223-5370 Rajankumar Naik, MD Health Plan Provider ID Aetna Non-Participating BCBS (Florida Blue) 04252 CarePlus Health Plans 1080575 Cigna QMP000004660779 Devoted Health LX2HHF-AB Freedom Health P102283J Health Plan Provider ID Humana 126353 Medicare Florida 04252Q Optimum Healthcare P200060J Simply Healthcare 06057254 - Closed Ultimate Health Plans 200000040394 - Closed United Healthcare 00040050741 WellCare 1649775 MaxHealth - Clearwater | S Fort Harrison Ave PINELLAS COUNTY | TAMPA BAY 14 Provider Directory | MaxHealth | www.mymaxdoc.com Ashti Khargu, APRN
3253 McMullen Booth Rd STE 200 Clearwater, FL 33761 P: (727) 725-6170 | F: (727) 799-3511 MaxHealth - Clearwater | McMullen Booth Rd Richard Maza, MD TAMPA BAY | PINELLAS COUNTY 15 Provider Directory | MaxHealth | www.mymaxdoc.com Health Plan Provider ID Aetna 4348924 BCBS (Florida Blue) 62280 CarePlus Health Plans Non-Participating Cigna QMP000004548172 - Open Devoted Health Non-Participating Freedom Health Non-Participating Health Plan Provider ID Humana Non-Participating Medicare Florida R9552 Optimum Healthcare Non-Participating Simply Healthcare Non-Participating Utimate Health Plans Non-Participating United Healthcare 000996400 WellCare Non-Participating Hemant Desai, MD Health Plan Provider ID Aetna Pending BCBS (Florida Blue) Pending CarePlus Health Plans Pending Cigna Pending Devoted Health Pending Freedom Health Pending Health Plan Provider ID Humana Pending Medicare Florida UJ330 Optimum Healthcare Pending Simply Healthcare Pending Utimate Health Plans Pending United Healthcare Pending WellCare Pending
13020 Park Boulevard Seminole, FL 33776 P: (727) 393-3404 | F: (727) 392-3663 MaxHealth - Seminole | Park Blvd Todd Clarkson, DO Erica Horstman, DO Health Plan Provider ID Aetna 7853981 BCBS (Florida Blue) 42049 CarePlus Health Plans 1185551 Cigna QMP000004660585 Devoted Health LX22UJ-AB Freedom Health P00113262A Health Plan Provider ID Humana 125282 Medicare Florida PK952 Optimum Healthcare P00076452A Simply Healthcare 06065258 Ultimate Health Plans 200000017776 - Closed UnitedHealthcare 00010069193 WellCare 1582539 Health Plan Provider ID Aetna 4953336 BCBS (Florida Blue) 14R70 CarePlus Health Plans 1185550 Cigna QMP000004660771 Devoted Health LX22UJ-AA Freedom Health P1009568B Health Plan Provider ID Humana 125282 Medicare Florida PK955 Optimum Healthcare P949045B Simply Healthcare 06064907 Ultimate Health Plans 200000018187 - Closed United Healthcare 00010073502 WellCare 1573862 Jasmine Naik, PA PINELLAS COUNTY | TAMPA BAY 16 Provider Directory | MaxHealth | www.mymaxdoc.com Monica Malone, MSN, FNP-BC
4446 East Fletcher Avenue, Suite D Tampa, FL 33613 P: (813) 972-2974 | F: (813) 866-7227 Carlos A. Silva, MD MaxHealth - Tampa | E Fletcher Ave Eric Wilcox, PA Yordanys Valdes, APRN Health Plan Provider ID Aetna 0007236032 - Closed BCBS (Florida Blue) 49111 - Closed CarePlus Health Plans 1053272 - Closed Cigna QMP000005082152 - Closed Devoted Health LX33R4-AA - Closed Freedom Health P02616A - Closed Health Plan Provider ID Humana 128552 Medicare Florida OA109 - Closed Optimum Healthcare P984794A - Closed Simply Healthcare Non-Participating Ultimate Health Plans Non-Participating United Healthcare 001944969- Closed WellCare Non-Participating TAMPA BAY | HILLSBOROUGH COUNTY 17 Provider Directory | MaxHealth | www.mymaxdoc.com
14003 North Dale Mabry Highway, Suite A Tampa, FL 33618 P: (813) 961-9174 | F: (813) 961-7338 MaxHealth - Tampa | N Dale Mabry Hwy Patrick Capri, MD Patricia Blessing, APRN Health Plan Provider ID Aetna 4251556 Alignment Health Plan 1841357951 BayCare 1841357951AA BCBS (Florida Blue) 73285 CarePlus Health Plans 1007751 Cigna QMP000004680868 Devoted Health LX7EKR-AA Freedom Health P1006148A Health Plan Provider ID Humana 128416 Medicare Florida M0980 Optimum Healthcare P946094A Simply Healthcare 10364866 Ultimate Health Plans 200000021604 - Closed United Healthcare 000809331 WellCare 2277424 Tracy Kodiyan, MD Health Plan Provider ID Aetna 6747226 BCBS (Florida Blue) G174V - Closed CarePlus Health Plans 1225245 Cigna QMP000005449798 Devoted Health LX328R-AC Freedom Health P00051884 Health Plan Provider ID Humana 128416 Medicare Florida PS913 Optimum Healthcare P00043231 Simply Healthcare 15074558 Ultimate Health Plans 20000042375 - Closed United Healthcare 8233103 WellCare 3262007 HILLSBOROUGH COUNTY | TAMPA BAY 18 Provider Directory | MaxHealth | www.mymaxdoc.com
4728 North Habana Avenue, Suite 102 Tampa, FL 33614 P: (813) 915-9000 | F: (813) 930-2701 Nilsa Sanchez, MD MaxHealth - Tampa | N Habana Ave Health Plan Provider ID Aetna 6903420 - Closed BCBS (Florida Blue) YX4SN CarePlus Health Plans 1179468 Cigna QMP000004711649 Devoted Health LX2F4C-AB Freedom Health P00004617E Health Plan Provider ID Humana 126429 Medicare Florida L9936 Optimum Healthcare P00004258D Simply Healthcare 11190395 Ultimate Health Plans 200000020179 United Healthcare 002402826 - Closed WellCare 2188242 TAMPA BAY | HILLSBOROUGH COUNTY 19 Provider Directory | MaxHealth | www.mymaxdoc.com Guillermo Talero, MD Health Plan Provider ID Aetna 7994691 BCBS (Florida Blue) 57909 CarePlus Health Plans 1072510 Cigna QMP000004700179 Devoted Health LX2F4C-AA Freedom Health P116098D Health Plan Provider ID Humana 126429 Medicare Florida BT234Y Optimum P00004810C Simply Healthcare 06064433 Ultimate Health Plan 200000020181 United Healthcare 00441395 - Closed WellCare 302038
5919 Webb Rd Tampa, FL 33615 P: (813) 269-6426 | F: (813) 342-5261 MaxHealth - Tampa | Webb Rd Alan Zloto, MD Health Plan Provider ID Aetna 4235945 BCBS (Florida Blue) 82780 CarePlus Health Plans 1182855 Cigna QMP000004624411 Devoted Health LX328R-AB Freedom Health P303190A Health Plan Provider ID Humana 128507 Medicare Florida OC511 Optimum Healthcare P938075A Simply Healthcare 10335848 - Closed Ultimate Health Plans 20000020182 United Healthcare 00040073087 WellCare 2277410 HILLSBOROUGH COUNTY | TAMPA BAY 20 Provider Directory | MaxHealth | www.mymaxdoc.com Ignacio Ranero, MD Health Plan Provider ID Aetna Pending BCBS (Florida Blue) Pending CarePlus Health Plans Pending Cigna Pending Devoted Health Pending Freedom Health Pending Health Plan Provider ID Humana Pending Medicare Florida Pending Optimum Healthcare Pending Simply Healthcare Pending Ultimate Health Plans Pending United Healthcare Pending WellCare Pending
Hiram Cuevas, MD Health Plan Provider ID Aetna 4066399 BCBS (Florida Blue) 30785 CarePlus Health Plans 1053270 Cigna QMP000004660766 Devoted Health LX328R-AD - Closed Freedom Health P100211A Health Plan Provider ID Humana 128507 Medicare Florida PK950 Optimum Healthcare P0004609A Simply Healthcare 06064306 - Closed Ultimate Health Plans 200000020172 United Healthcare 001653398 WellCare 07449 Amado Castellon, APRN Tampa | Webb Rd Cont. TAMPA BAY | HILLSBOROUGH COUNTY 21 Provider Directory | MaxHealth | www.mymaxdoc.com
MaxHealth - Brandon | S Kings Ave (Relocated to Brandon Lithia) HILLSBOROUGH COUNTY | TAMPA BAY 22 Provider Directory | MaxHealth | www.mymaxdoc.com 1111 Lithia Pinecrest Rd, Brandon, FL 33511 New Address
1111 Lithia Pinecrest Rd Brandon, FL 33511 P: (813) 643-3242 | F: (813) 643-3090 MaxHealth - Brandon | Lithia Pinecrest Rd Izabela Shaw, MD Health Plan Provider ID Aetna 7890371 BCBS (Florida Blue) 13136 - Closed CarePlus Health Plans 1058443 - Closed Cigna QMP000002347178 Devoted Health LX33C2-AD - Closed Freedom Health P306528 - Closed Health Plan Provider ID Humana 128774 Medicare Florida T3461 - Closed Optimum Healthcare P929671 - Closedv Simply Healthcare 23523387 - Closed Ultimate Health Plan Non-Participating United Healthcare 002251327 - Closed WellCare 3260097 - Closed TAMPA BAY | HILLSBOROUGH COUNTY 23 Provider Directory | MaxHealth | www.mymaxdoc.com Halide Kattan, MD Health Plan Provider ID Aetna 7512190 BCBS (Florida Blue) 44756 CarePlus Health Plans 1021027 Cigna QMP000004625017 Devoted Health LX33C2-AD Freedom Health P107014 - Closed Health Plan Provider ID Humana Center #128774 Medicare Florida Pending Optimum Healthcare P510681 - Closed Simply Healthcare 23523387 Ultimate Health Plans Non-Participating United Healthcare Pending WellCare Pending
2507 Thonotosassa Road Plant City, FL 33563 P: (813) 608-3101 | F: (813) 608-3102 MaxHealth - Plant City | Thonotosassa Rd Ignacio Ranero, MD Health Plan Provider ID Aetna 6665756 BCBS (Florida Blue) 5788K CarePlus Health Plans 1206605 Cigna QMP000005118836 Devoted Health LX2FFY-AA Freedom Health P0003488 Health Plan Provider ID Humana 128641 Medicare Florida OC562 Optimum Healthcare P00028048 Simply Healthcare 11777439 Ultimate Health Plans 200000039160 United Healthcare 00010096672 WellCare 2680127 HILLSBOROUGH COUNTY | TAMPA BAY 24 Provider Directory | MaxHealth | www.mymaxdoc.com
12967 US-301 S Riverview, FL 33578 P: (813) 443-6369 | F: (813) 280-2584 MaxHealth - Riverview | US-301 S Angel Pagan, MD Amado Castellon, APRN Health Plan Provider ID Aetna 7427593 - Open BCBS (Florida Blue) PQZE1 CarePlus Health Plans 1225677 Cigna QMP000004895224 Devoted Health LX2F5W-AC Freedom Health P1059537I Health Plan Provider ID Humana 128511 Medicare Florida OC511 Optimum Healthcare P00076464H Simply Healthcare 1184941 - Closed Ultimate Health Plan 200000021694 United Healthcare 00010096673 - Open WellCare 1505096 TAMPA BAY | HILLSBOROUGH COUNTY 25 Provider Directory | MaxHealth | www.mymaxdoc.com
2382 Griffin Road Lakeland, FL 33810 P: (863) 225-2627 | F: (863) 606-6011 MaxHealth - Lakeland | Griffin Rd Jose Sanchez Ojeda, MD Health Plan Provider ID Aetna Non-Participating BCBS (Florida Blue) JL02C CarePlus Health Plans 1134373 Cigna Non-Participating Devoted Health Non-Participating Freedom Health P1059537I Health Plan Provider ID Humana 126369 Medicare Florida NE948 Optimum Healthcare P979418 Simply Healthcare 10901477 Ultimate Health Plans Non-Participating United Healthcare 006811426 WellCare 2399379 POLK COUNTY | CENTRAL FLORIDA 26 Provider Directory | MaxHealth | www.mymaxdoc.com Jessica Concepcion, FNP
Preeti Harchandani, MD 405 South 11th Street Lake Wales, FL 33853 MaxHealth - Lake Wales | S 11th St Sunil Nihalani, MD Linesha Davis PA P: (863) 679-8000 | F: (863) 679-2694 Health Plan Provider ID Aetna 7419405 BCBS (Florida Blue) 51547 CarePlus Health Plans 1074299 - Closed Cigna QMP000004777175 Devoted Health LXG6JG-AA Freedom Health Plan P999118A Health Plan Provider ID Humana 128553 Medicare Florida 51547Z Optimum P204481A Simply Healthcare 12183054 Ultimate Health Plan 200000040469 - Closed United Healthcare 002245509 - Closed WellCare 2306317 Health Plan Provider ID Aetna 5713697 - Closed BCBS (Florida Blue) 44347 - Closed CarePlus Health Plans 1106147 - Closed Cigna QMP000004400745 - Closed Devoted Health LXG6JG-AB - Closed Freedom Health P989512A - Closed Health Plan Provider ID Humana 128553 - Closed Medicare Florida OA223 - Closed Optimum Healthcare P511792A - Closed Simply Healthcare 12018114 - Closed Ultimate Health Plan 200000040322 - Closed United Healthcare 001838144 - Closed WellCare 2303531 - Closed CENTRAL FLORIDA | POLK COUNTY 27 Provider Directory | MaxHealth | www.mymaxdoc.com
2209 North Boulevard West Davenport, FL 33837 P: (863) 679-8000 | F: (863) 679-2694 MaxHealth - Davenport | North Blvd W Ricci Cahili APRN Jorge Salcedo, MD Health Plan Provider ID Aetna 7252726 BCBS (Florida Blue) E14UX CarePlus Health Plans 1246870 Cigna QMP000002269165 Devoted Health LX3J8F-AA Freedom Health P00073142 Freedom Health P101550D Health Plan Provider ID POLK COUNTY | CENTRAL FLORIDA 28 Provider Directory | MaxHealth | www.mymaxdoc.com Preeti Harchandani, MD Sunil Nihalani, MD Health Plan Provider ID Aetna 7419405 BCBS (Florida Blue) 51547 CarePlus Health Plans 1074299 - Closed Cigna QMP000004777175 Devoted Health LXG6JG-AA Freedom Health P999118A Health Plan Provider ID Humana 128553 Medicare Florida 51547Z Optimum P204481A Simply Healthcare 12183054 Ultimate Health Plan 200000040469 - Closed United Healthcare 002245509 - Closed WellCare 2306317 Health Plan Provider ID Aetna 5713697 - Closed BCBS (Florida Blue) 44347 - Closed CarePlus Health Plans 1106147 - Closed Cigna QMP000004400745 - Closed Devoted Health LXG6JG-AB - Closed Freedom Health P989512A - Closed Health Plan Provider ID Humana 128553 - Closed Medicare Florida OA223 - Closed Optimum Healthcare P511792A - Closed Simply Healthcare 12018114 - Closed Ultimate Health Plan 200000040322 - Closed United Healthcare 001838144 - Closed WellCare 2303531 - Closed Humana 128554 Medicare Florida R1883 Optimum Healthcare P00056936 Simply Healthcare 20261731 Ultimate Health Plans 200000049953 United Healthcare 002955159 WellCare 3884707
28149 US Hwy 27 Dundee, FL 33837 P: (863) 422-5476 | F: (863) 438-9095 MaxHealth - Dundee | HWY 27 POLK COUNTY | CENTRAL FLORIDA 29 Provider Directory | MaxHealth | www.mymaxdoc.com Christopher Mondello, DO Health Plan Provider ID Aetna 4229460 BCBS (Florida Blue) 80217 CarePlus Health Plans 1073456 Cigna QMP000003641299 Devoted Health LX2994-AA Freedom Health P112257 Health Plan Provider ID Humana Pending Medicare Florida UD172 Optimum P944667 Simply Healthcare Non-Participating Ultimate Health Plan Non-Participating United Healthcare Pending WellCare 4425158 Tamika Dowling, DNP Donna Perkins, APRN
10900 S.E. 174th Place Road Summerfield, FL 34491 P: (352) 820-3401 | F: (352) 820-3402 MaxHealth - Summerfield | SE 174th Place Rd Jorge Alfonso, MD Health Plan Provider ID Aetna 5548209 BCBS (Florida Blue) PID 06740 CarePlus Health Plans PID 1089974 Cigna QMP000005185489 Devoted Health LX2AAJ-AD Freedom Health P1057801 Health Plan Provider ID Humana 134698 Medicare Florida SX075 Optimum Healthcare P989310 Simply Healthcare Non-participating Ultimate Health Plans 200000051725 United Healthcare 002217597 WellCare 4093308 Health Plan Provider ID Health Plan Provider ID CENTRAL FLORIDA | MARION COUNTY 30 Provider Directory | MaxHealth | www.mymaxdoc.com Tamika Dowling, DNP
5814 Seven Mile Drive, Suite 105 Wildwood, FL 34785 P: (352) 815-5030 | F: (352) 815-5031 MaxHealth - Wildwood | Seven Mile Dr SUMTER COUNTY | CENTRAL FLORIDA 31 Provider Directory | MaxHealth | www.mymaxdoc.com Jorge Alfonso, MD Health Plan Provider ID Aetna 5548209 BCBS (Florida Blue) 06740 CarePlus Health Plans 1089975 Cigna QMP000005185489 Devoted Health LX2AAJ-AD Freedom Health P1057801 Health Plan Provider ID Humana 134698 Medicare Florida SX075 Optimum Healthcare P989310 Simply Healthcare Non-participating Ultimate Health Plans 200000051725 United Healthcare 002217597 WellCare 4093308 Health Plan Provider ID Health Plan Provider ID
1530 Celebration Boulevard, Suite 407 Celebration, FL 34747 P: (321) 939-4137 | F: (321) 939-4109 MaxHealth - Celebration | Celebration Blvd CENTRAL FLORIDA | OSCEOLA COUNTY 32 Provider Directory | MaxHealth | www.mymaxdoc.com Jorge Salcedo, MD Health Plan Provider ID Aetna 252726 BCBS (Florida Blue) E14UX CarePlus Health Plans 1246966 Cigna QMP000002269165 Devoted Health LX3J8F-AA Freedom Health P00073142 Health Plan Provider ID Humana 134697 Medicare Florida R1883 Optimum Healthcare P00056936 Simply Healthcare Non-Participating Ultimate Health Plans 200000049953 United Healthcare 002955159 WellCare 3884707
425 Nursing Home Drive Suite 1 Arcadia, FL 34266 P: (863) 993-2966 | F: (863) 494-5491 MaxHealth - Arcadia | Nursing Home Drive DESOTO COUNTY | CENTRAL FLORIDA 33 Provider Directory | MaxHealth | www.mymaxdoc.com Kara Lomski, APRN Samir Dawod Rajiha, MD Health Plan Provider ID Aetna 4767483 BCBS (Florida Blue) KN17I CarePlus Health Plans Non-Participating Cigna QMP000004613054 Devoted Health 1053751149- Open Freedom Health Non-Participating Health Plan Provider ID Humana Center #129118 Medicare Florida TC948 Optimum Healthcare Non-Participating Simply Healthcare 22173978 Ultimate Health Plans Non-Participating United Healthcare 005971830 WellCare Pending Medicare 00040075488 Wael Alokeh, MD Health Plan Provider ID Aetna 7888529 BCBS (Florida Blue) 1815 CarePlus Health Plans Non-Participating Cigna QMP000004775131 Devoted Health LX4483-AA Freedom Health Non-Participating Health Plan Provider ID Humana Center #129118 Medicare Florida TC951 Optimum Healthcare Non-Participating Simply Healthcare 22167251 Ultimate Health Plans Non-Participating United Healthcare 002393750 WellCare 4254934 Georgia Varner, APRN Jenny Vest, APRN
508 S 6th Ave Wauchula, FL 33873 P: (863) 473-4733 | F: (863) 473-4733 MaxHealth - Wauchula | S 6th Av HARDEE COUNTY | CENTRAL FLORIDA 34 Provider Directory | MaxHealth | www.mymaxdoc.com Georgia Varner, APRN Wael Alokeh, MD Health Plan Provider ID Aetna 7888529 BCBS (Florida Blue) 1815 CarePlus Health Plans Non-Participating Cigna QMP000004775131 Devoted Health LX4483-AA Freedom Health Non-Participating Health Plan Provider ID Humana 129121 Medicare Florida TC951 Optimum Healthcare Non-Participating Simply Healthcare 22167251 Ultimate Health Plans Non-Participating United Healthcare 02393750 WellCare 4252090
4401 Cortez Road West Bradenton, FL 34210 P: (941) 357-5550 | F: (941) 792-7152 MaxHealth - Bradenton | Cortez Rd W | 1 Brian Zeidan, MD Anjuli BhaduriHauk, DO Health Plan Provider ID Aetna 6463574 BCBS (Florida Blue) TDV2L CarePlus Health Plans Non-Participating Cigna QMP000005101012 Devoted Health LX2AHA-AD Freedom Health P00041569 Health Plan Provider ID Humana 126393 HMO 124229 PPO Medicare Florida OO543 Optimum Healthcare P00036048 Simply Healthcare Non-Participating Ultimate Health Plan 200000040698 United Healthcare 00010777312 WellCare 3174606 Health Plan Provider ID Aetna 8781096 BCBS (Florida Blue) QVZMR CarePlus Health Plans Non-Participating Cigna QMP000005800939 Devoted Health LX2AHA-AH Freedom Health P00057266 Health Plan Provider ID Humana 126393 Medicare Florida QI605 Optimum Healthcare P00048677 Simply Healthcare Non-Participating Ultimate Health Plan 200000045190 UnitedHealthcare 8577506 WellCare 3633790 MANATEE COUNTY | GULF COAST 35 Provider Directory | MaxHealth | www.mymaxdoc.com Shahnaz Ahmed, MD Health Plan Provider ID Aetna 5056674 - Closed BCBS (Florida Blue) 43984 - Closed CarePlus Health Plans Non-Participating Cigna QMP000005069026 - Closed Devoted Health LX2AHA-AC - Closed Freedom Health P101543C - Closed Health Plan Provider ID Humana 126393 HMO - Closed 124229 PPO - Closed Medicare Florida 8577506 - Closed Optimum Healthcare P204581B - Closed Simply Healthcare Non-Participating Ultimate Health Plan 200000039772 - Closed United Healthcare 00040075445 - Closed WellCare 3178711 - Closed
Aruna Narasimman, MD Bradenton | Cortez Road West | 1 Cont. Health Plan Provider ID Aetna 7171305 - Closed BCBS (Florida Blue) 51564 - Closed CarePlus Health Plans Non-Participating Cigna QMP000004244726 - Closed Devoted Health LX2AHA-AB - Closed Freedom Health P101548C - Closed Health Plan Provider ID Humana 126393 HMO - Closed 124229 PPO - Closed Medicare Florida 51564X - Closed Optimum Healthcare P930021B - Closed Simply Healthcare Non-Participating Ultimate Health Plans 200000039878 - Closed United Healthcare 002017444004 - Closed WellCare 3176026 - Closed Naderge Dumorne, MD Health Plan Provider ID Aetna 5235820 BCBS (Florida Blue) UY45L CarePlus Health Plans Non-Participating Cigna QMP000006115995 Devoted Health LX2AHA-AJ Freedom Health P1025913 Health Plan Provider ID Humana 126393 - HMO 124229- PPO Medicare Florida RD804 Optimum Healthcare P966883 Simply Healthcare 19757570 Ultimate Health Plans 200000047650 United Healthcare 005339909 WellCare 3643195 GULF COAST | MANATEE COUNTY 36 Provider Directory | MaxHealth | www.mymaxdoc.com Jennifer Lynn Haughey, MSN, FNP-BC Irina Danilova, APRNv
Krystina Hadra, PA 4502 Cortez Road, Suite 205 Bradenton, FL 34210 P: (941) 259-8505 | F: (941) 259-8501 MaxHealth - Bradenton | Cortez Rd W | 2 Suguna Kona, MD Health Plan Provider ID Aetna 7100625 BCBS (Florida Blue) 13050 CarePlus Health Plans Non-Participating Cigna QMP000003924623 Devoted Health LX2AKY-AA Freedom Health P101545D Health Plan Provider ID Humana 126525 HMO Medicare Florida 13050W Optimum Healthcare P204548C Simply Healthcare Non-Participating Ultimate Health Plan 200000040485 United Healthcare 00040075490 - Closed WellCare 3174590 MANATEE COUNTY | GULF COAST 37 Provider Directory | MaxHealth | www.mymaxdoc.com
Donna Losco, MD 250 2nd Street E Bradenton, FL 34208 P: (941) 243-3983 | F: (941) 896-3795 MaxHealth - Bradenton | 2nd St E Health Plan Provider ID Aetna 5508572 BCBS (Florida Blue) 1S8J2 CarePlus Health Plans Non-Participating Cigna 1083676597 Devoted Health LX448W-AB Freedom Health P1044420 – Open Health Plan Provider ID Humana 128999 Medicare Florida RB222 Optimum P00052968 Simply Healthcare 19551254 Ultimate Health Plan 200000047444 United Healthcare 001850301 WellCare 3743287 GULF COAST | MANATEE COUNTY 38 Provider Directory | MaxHealth | www.mymaxdoc.com Drew Edwards, MD Health Plan Provider ID Aetna 5508572 BCBS (Florida Blue) HJI5P CarePlus Health Plans Non-Participating Cigna QMP000005612768 Devoted Health LX448W-AA Freedom Health P00080664 Health Plan Provider ID Humana Center #128999 Medicare Florida SQ773 Optimum Healthcare P00063372 Simply Healthcare Non-Participating Ultimate Health Plans Non-Participating United Healthcare 001050046 WellCare Non-Participating
701 Manatee Ave West Suite 101 Bradenton, FL 34205 P: (941) 748-3065 | F: (941) 748-3065 MaxHealth - Bradenton | 701 Manatee Ave W GULF COAST | MANATEE COUNTY 39 Provider Directory | MaxHealth | www.mymaxdoc.com Santa Guerra, PA-C Frank Oliver, DO Health Plan Provider ID Aetna 8787025 BCBS (Florida Blue) EPFH3 CarePlus Health Plans Non-Participating Cigna QMP000006112983 Devoted Health LX39U6-AB Freedom Health Non-Participating Health Plan Provider ID Humana Center #129119 Medicare Florida TC939 Optimum Healthcare Non-Participating Simply Healthcare 22174343 Ultimate Health Plans Non-Participating United Healthcare 008840949 WellCare 4247122 Christopher Corriveau, APRN
5225 Manatee Avenue West Bradenton, FL 34209 P: (941) 708-8081 | F: (941) 708-8085 MaxHealth - Bradenton | 5225 Manatee Ave W GULF COAST | MANATEE COUNTY 40 Provider Directory | MaxHealth | www.mymaxdoc.com Ronald Grubb, MD Health Plan Provider ID Aetna 5904020 BCBS (Florida Blue) 14TJ9 CarePlus Health Plans Non-Participating Cigna QMP000005612768 Devoted Health LX2HFA-AB Freedom Health Non-Participating Health Plan Provider ID Humana Center #129110 Medicare Florida SQ103 Optimum Healthcare Non-Participating Simply Healthcare Non-Participating Ultimate Health Plan Non-Participating United Healthcare 001742608 WellCare Non-Participating Kristof Michaels, DO Health Plan Provider ID Aetna 5685912 BCBS (Florida Blue) VE8P0 CarePlus Health Plans Non-Participating Cigna QMP000004743021 Devoted Health LX2HFA-AA Freedom Health Non-Participating Health Plan Provider ID Humana Center #129110 Medicare Florida SQ104 Optimum Healthcare Non-Participating Simply Healthcare Non-Participating Ultimate Health Plans Non-Participating United Healthcare 006447973 WellCare Non-Participating
7431 Manatee Avenue West Bradenton, FL 34209 P: (941) 313-7142 | F: (941) 794-2805 MaxHealth - Bradenton | 7431 Manatee Ave W Scott Clulow, DO Padmini Rajan, MD Health Plan Provider ID Aetna 7715358 - Closed BCBS (Florida Blue) 62157 - Closed CarePlus Health Plans Non-Participating Cigna QMP000005069028 - Closed Devoted Health LX2HGZ-AC - Closed Freedom Health Non-Participating Health Plan Provider ID Humana 126394 HMO - Closed 163443 PPO - Closed Medicare Florida 62157U - Closed Optimum Healthcare Non-Participating Simply Healthcare Non-Participating Ultimate Health Plans 200000040640 - Closed United Healthcare Non-Participating WellCare 3174691 - Closed Health Plan Provider ID Aetna 4253655 BCBS (Florida Blue) 04502 CarePlus Health Plans Non-Participating Cigna QMP0000023 Devoted Health LX2HGZ-AE Freedom Health P101857F Health Plan Provider ID Humana 126394 Medicare Florida OX233 Optimum Healthcare P511424E Simply Healthcare Non-Participating Ultimate Health Plan 200000039892 United Healthcare 40553586 WellCare 3178673 MANATEE COUNTY | GULF COAST 41 Provider Directory | MaxHealth | www.mymaxdoc.com Nina Lundberg, MD Health Plan Provider ID Aetna 4877027 BCBS (Florida Blue) NTFPF - Closed CarePlus Health Plans Non-Participating Cigna QMP000004540148 - Closed Devoted Health LX2HGZ-AF Freedom Health P00007118 Health Plan Provider ID Humana MAHMO - Center #126394 Comm/MAPPO - Center #163443 Medicare Florida TG059 Optimum Healthcare P00061379 Simply Healthcare Non-Participating Ultimate Health Plans 200000054334 United Healtvhcare 006208533 Katrina Mylett, APRN Jennifer Lynn Haughey, MSN, FNP-BC
6110 53rd Avenue East (State Road 70 East) Bradenton, FL 34203 P: (941) 755-4242 | F: (941) 755-1906 MaxHealth - Bradenton | 53rd Ave E Milena Khorshid, MD Stephen Coppa, DO Michael Dale, PA Marisa Fullgrapp, PA-C Health Plan Provider ID Aetna 7918203 - Closed BCBS (Florida Blue) 82311 - Closed CarePlus Health Plans Non-Participating Cigna QMP000005069029 - Closed Devoted Health LX2AH6-AA - Closed Freedom Health P101550D Health Plan Provider ID Humana 126395 HMO - Closed 124599 PPO - Closed Medicare Florida 82311W - Closed Optimum Healthcare P930020B - Closed Simply Healthcare Non-Participating Ultimate Health Plans 200000040421 - Closed United Healthcare 00040075488 WellCare 3177787 - Closed Health Plan Provider ID Aetna 7849739 - Closed BCBS (Florida Blue) TWKR5 - Closed CarePlus Health Plans Non-Participating Cigna QMP000004548027 - Closed Devoted Health LX2J6H-AA Freedom Health P0039747 Health Plan Provider ID Humana 126395 - Closed Medicare Florida OC339 Optimum Healthcare P00033616 Simply Healthcare Non-Participating Ultimate Health Plans 200000039858 - Closed United Healthcare 00040076990 - Closed WellCare 3176488 - Closed GULF COAST | MANATEE COUNTY 42 Provider Directory | MaxHealth | www.mymaxdoc.com
7915 US-301 N, Suite 107 Ellenton, FL 34222 P: (941) 847-1101 | F: (941) 417-2811 MaxHealth - Ellenton | US-301 N Gary (Joe) Laubacker, DO Health Plan Provider ID Aetna 9584827 - Closed BCBS (Florida Blue) 14U4J - Closed CarePlus Health Plans Non-Participating Cigna QMP000005170478 - Closed Devoted Health LX2AHW-AA - Closed Freedom Health P1019489C - Closed Health Plan Provider ID Humana 126396 HMO - Closed 128029 PPO - Closed Medicare Florida NI681 - Closed Optimum P964467C - Closed Simply Healthcare Non-Participating Ultimate Health Plans 200000040490 UnitedHealthcare 00040076463 - Closed WellCare 3176624 - Closed Maniekha Maharaj, MD Health Plan Provider ID Aetna 8222994 BCBS (Florida Blue) 0GZNW CarePlus Health Plans Non-Participating Cigna QMP000006057143- Open Devoted Health LX2AHW-AE Freedom Health P00062010 Health Plan Provider ID Humana 126396 - HMO Medicare Florida Q1984 Optimum Healthcare P00052814 Simply Healthcare Non-Participating Ultimate Health Plan 200000047646 United Healthcare 008810523 WellCare 3647208 Monica Cruz, APRN MANATEE COUNTY | GULF COAST 43 Provider Directory | MaxHealth | www.mymaxdoc.com
11505 Palmbrush Trail, Suite 220 Lakewood Ranch, FL 34202 P: (941) 747-2090 | F: (941) 556-7785 MaxHealth - Lakewood Ranch | Palmbrush Trl Daniela Kassabov, MD Tatiana Dorenko, APRN Wesley Hardin, PA-C Mirsen Lekovic, MD Health Plan Provider ID Aetna 4787106 - Closed BCBS (Florida Blue) 14QU4 - Closed CarePlus Health Plans Non-Participating Cigna QMP000005069032 - Closed Devoted Health LX2AHS-AB - Closed Freedom Health P1007749B - Closed Health Plan Provider ID Humana 126397 HMO - Closed 124423 PPO - Closed Medicare Florida HH248Z - Closed Optimum Healthcare P966702A - Closed Simply Healthcare Non-Participating Ultimate Health Plans 200000040481 - Closed United Healthcare 00010727053 - Closed WellCare 3178845 - Closed Health Plan Provider ID Aetna 4839526 - Closed BCBS (Florida Blue) BHYQ8 - Closed CarePlus Health Plans Non-Participating Cigna QMP000005083425 - Closed Devoted Health LX2AHS-AC - Closed Freedom Health P00031462A - Closed Health Plan Provider ID Humana 126397 HMO - Closed 124423 PPO - Closed Medicare Florida M8510 - Closed Optimum Healthcare P00026994A - Closed Simply Healthcare Non-Participating Ultimate Health Plans 200000040492 - Closed United Healthcare 00010096445 - Closed WellCare 3177832 - Closed GULF COAST | MANATEE COUNTY 44 Provider Directory | MaxHealth | www.mymaxdoc.com
606 4th Avenue West, Palmetto, FL 34221 P: (941) 722-7785 | F: (941) 729-5267 MaxHealth - Palmetto | 4th Ave W Angel Llanio, DO Health Plan Provider ID Aetna 5464831 BCBS (Florida Blue) 14UK7 CarePlus Health Plans Non-Participating Cigna QMP000004928984 Devoted Health LX2HCG-AC Freedom Health Non-Participating Health Plan Provider ID Humana Center #129108 Medicare Florida ST019 Optimum Healthcare Non-Participating Simply Healthcare Non-Participating Ultimate Health Plans Non-Participating United Healthcare 004301303 WellCare Non-Participating Ryan Zaleski, DO Health Plan Provider ID Aetna 6629828 BCBS (Florida Blue) SV3QC CarePlus Health Plans Non-Participating Cigna QMP000005783025 Devoted Health LX2HCG-AB Freedom Health Non-Participating Health Plan Provider ID Humana 129108 Medicare Florida SQ793 Optimum Healthcare Non-Participating Simply Healthcare Non-Participating Ultimate Health Plans Non-Participating United Healthcare 007009964 WellCare Non-Participating Reagan Schoppelrey, MSN, APRN, FNP-C MANATEE COUNTY | GULF COAST 45 Provider Directory | MaxHealth | www.mymaxdoc.com Manuel Martinez, MD Health Plan Provider ID Aetna Pending BCBS (Florida Blue) Pending CarePlus Health Plans Pending Cigna Pending Devoted Health Pending Freedom Health Pending Health Plan Provider ID Humana Pending Medicare Florida UN545 Optimum Healthcare Pending Simply Healthcare Pending Ultimate Health Plans Pending United Healthcare Pending WellCare Pending
1211 Jacaranda Boulevard, Suite 2 Venice, FL 34292 P: (941) 483-3377 | F: (941) 483-4687 MaxHealth - Venice | Jacaranda Blvd Mateusz Zagata, MD Eric Lough, MD Ann Piscitelli, MD Health Plan Provider ID Aetna 5656780 BCBS (Florida Blue) 35473 CarePlus Health Plans Non-Participating Cigna QMP000005084449 Devoted Health LX2AH5-AC Freedom Health P105231C Health Plan Provider ID Humana 128391 HMO 128278 PPO Medicare Florida L5378 Optimum Healthcare P944019C Simply Healthcare Non-Participating Ultimate Health Plans 200000040498 United Healthcare 00040075486 WellCare 3174705 Health Plan Provider ID Aetna 7621699 BCBS (Florida Blue) 35474 CarePlus Health Plans Non-Participating Cigna QMP000005069039 Devoted Health LX2AH5-AB Freedom Health P987322C Health Plan Provider ID Humana 128391 HMO 128378 PPO Medicare Florida 35472 Optimum Healthcare P950092B Simply Healthcare Non-Participating Ultimate Health Plans 200000040336 United Healthcare 1996999 WellCare 3174617 Health Plan Provider ID Aetna 724614 - Closed BCBS (Florida Blue) HBTWQ CarePlus Health Plans Non-Participating Cigna QMP000003728960 Devoted Health LX2AH5-AA Freedom Health P1009288C Health Plan Provider ID Humana 128391 HMO Medicare Florida M8052 Optimum Healthcare P972491B Simply Healthcare Non-Participating Ultimate Health Plans 200000040386 United Healthcare 00010096432 WellCare 3884338 GULF COAST | SARASOTA COUNTY 46 Provider Directory | MaxHealth | www.mymaxdoc.com Linda Martell, APRN
4451 Aidan Lane, Unit 201 North Port, FL 34287 P: (941) 423-1111 | F: (941) 423-2274 MaxHealth - North Port | Aidan Lane Mary Lilko, DO Health Plan Provider ID Aetna 7814332 BCBS (Florida Blue) KMTG0 CarePlus Health Plans Non-Participating Cigna QMP000003627067 Devoted Health PID LX3AJH-AB Freedom Health P00047896 Health Plan Provider ID Humana 126485 HMO 128367 PPO Medicare Florida RO244 - Open Optimum Healthcare P981595 Simply Healthcare 20941978 Ultimate Health Plans 200000049489 United Healthcare 002084631 WellCare 3861350 SARASOTA COUNTY | GULF COAST 47 Provider Directory | MaxHealth | www.mymaxdoc.com
1435 Osprey Avenue, Suite 101 Sarasota, FL 34239 P: (941) 316-1550 | F: (941) 316-1552 MaxHealth - Sarasota | Osprey Ave Jose Manuel, MD Health Plan Provider ID Aetna 4920590 BCBS (Florida Blue) M875G CarePlus Health Plans Non-Participating Cigna QMP000005108863 Devoted Health LX2F6S-AC Freedom Health P00032220A Health Plan Provider ID Humana 128505 Medicare Florida M9940 Optimum Healthcare P00027519A Simply Healthcare Non-Participating Ultimate Health Plans 200000040506 United Healthcare 00010096446 WellCare 3174630 GULF COAST | SARASOTA COUNTY 48 Provider Directory | MaxHealth | www.mymaxdoc.com
3844 Bee Ridge Road Sarasota, FL 34233 P: (941) 379-8481 | F: (941) 379-3781 MaxHealth - Sarasota | Bee Ridge Rd Vanh Luangphakdy, MD Jeremy Benjaminson, DO Health Plan Provider ID Aetna 9206466 - Closed BCBS (Florida Blue) 146PT - Closed CarePlus Health Plans Non-Participating Cigna QMP000003868924 - Closed Devoted Health LX2K9H-AC - Closed Freedom Health P1010018A - Closed Health Plan Provider ID Humana 126399 HMO - Closed 163404 PPO - Closed Medicare Florida DD138Y - Closed Optimum Healthcare P949380A - Closed Simply Healthcare Non-Participating Ultimate Health Plans 200000040500 - Closed United Healthcare 00040075492 - Closed WellCare 3174723 - Closed Health Plan Provider ID Aetna 1661993 - Closed BCBS (Florida Blue) WLMLU - Closed CarePlus Health Plans Non-Participating Cigna QMP000004469839 - Closed Devoted Health LX2K9H-AB - Closed Freedom Health P1058141A - Closed Health Plan Provider ID Humana 126399 HMO - Closed 163404 PPO - Closed Medicare Florida JB080Z - Closed Optimum Healthcare P989611A - Closed Simply Healthcare Non-Participating Ultimate Health Plans 200000040394 - Closed United Healthcare 006472846 - Closed WellCare 3176648 - Closed SARASOTA COUNTY | GULF COAST 49 Provider Directory | MaxHealth | www.mymaxdoc.com Jose Manuel, MD Health Plan Provider ID Aetna 4920590 BCBS (Florida Blue) M875G CarePlus Health Plans Non-Participating Cigna QMP000005108863 - Closed Devoted Health LX2K9H-AA Freedom Health P00032220A Health Plan Provider ID Humana 126399 Medicare Florida M9940 Optimum Healthcare P00027519A Simply Healthcare Non-Participating Ultimate Health Plans 200000040506 United Healthcare 00010096446 WellCare 3174630
David Harris, MD Jyoti Yeli, MD Sarasota | Bee Ridge Rd Cont. Health Plan Provider ID Aetna 5922053 - Closed BCBS (Florida Blue) 11293 - Closed CarePlus Health Plans Non-Participating Cigna QMP000005098553 - Closed Devoted Health LX2K9H-AE - Closed Freedom Health P103580A - Closed Health Plan Provider ID Humana 126399 HMO - Closed 163404 PPO - Closed Medicare Florida 11293V - Closed Optimum Healthcare P944498A - Closed Simply Healthcare Non-Participating Ultimate Health Plan 200000040472 - Closed United Healthcare 00040075485 - Closed WellCare 3177849 - Closed Health Plan Provider ID Aetna 9270377 - Closed BCBS (Florida Blue) 145US - Closed CarePlus Health Plans Non-Participating Cigna QMP000005082376 - Closed Devoted Health LX2K9H-AD - Closed Freedom Health P1006445B - Closed Health Plan Provider ID Humana 126399 HMO - Closed 163404 PPO - Closed Medicare Florida CI406X - Closed Optimum Healthcare P946354B - Closed Simply Healthcare Non-Participating Ultimate Health Plans 200000040384 - Closed United Healthcare 00010096441 - Closed WellCare 3177810 - Closed GULF COAST | SARASOTA COUNTY 50 Provider Directory | MaxHealth | www.mymaxdoc.com