MEDICARE: MSHALF LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1457203689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MSHALF LLC

Provider Business Mailing Address
First Line	:	2425 OLD VINELAND RD LOT 62
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-5862
Country	:	US
Telephone Number	:	415-531-3173
Fax Number	:	415-376-4515

Provider Business Practice Location Address
First Line	:	1934 22ND AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-3084
Country	:	US
Telephone Number	:	415-531-3173
Fax Number	:	415-376-4515

Authorized Official
Title or Position	:	OWNER
Name	:	MARC EDWARD MARCHIOLI
Credential	:	OWNER
Telephone Number	:	415-531-3173

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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