Provider Demographics
NPI:1366603763
Name:MAGGIO, LINDSAY (MD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:MAGGIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10016 WELLNESS WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-7175
Mailing Address - Country:US
Mailing Address - Phone:689-208-1500
Mailing Address - Fax:
Practice Address - Street 1:65 JAMES ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3947
Practice Address - Country:US
Practice Address - Phone:732-321-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
PAMD468135207V00000X, 207VM0101X
FLME123761207VM0101X
NJ25MA10976500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No171400000XOther Service ProvidersHealth & Wellness Coach
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015267400Medicaid
FL150N7OtherBLUE CROSS BLUE SHIELD
FL150N7OtherBLUE CROSS BLUE SHIELD