Healthcare Provider Details

I. General information

NPI: 1982567996
Provider Name (Legal Business Name): MARVEL PSYCHIATRIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1277 N SEMORAN BLVD STE 103
ORLANDO FL
32807-3573
US

IV. Provider business mailing address

7940 WANDERING WAY
ORLANDO FL
32836-6893
US

V. Phone/Fax

Practice location:
  • Phone: 469-915-4211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: SEHER SHAIKH
Title or Position: CEO
Credential:
Phone: 469-915-4211