Healthcare Provider Details

I. General information

NPI: 1740465442
Provider Name (Legal Business Name): MARCIE A LAUZON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 09/04/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 NW 34TH CIRCLE SUITE 101
OCALA FL
34474-6617
US

IV. Provider business mailing address

4881 NW 8TH AVE SUITE 2
GAINESVILLE FL
32605-4582
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-3110
  • Fax: 352-732-0028
Mailing address:
  • Phone: 352-418-1082
  • Fax: 352-373-6144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA003592L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9116760
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: