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General NPI Number Information
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NPI Number | 1639450778
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Entity Type | Individual
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Provider Name | MARC EDWARD MARCHIOLI PA
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Gender | Male
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 410 S 11TH ST
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City | LAKE WALES
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State | FL
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Zip | 33853-4203
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Country | US
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Telephone | 407-303-7283
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Fax | 407-303-0473
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Provider Business Mailing Address
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Address Line | 410 S 11TH ST
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City | LAKE WALES
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State | FL
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Zip | 33853-4203
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Country | US
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Telephone | 407-303-7283
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Fax | 407-303-0473
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 965
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 965
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-TF-0188
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA3370
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601010961
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110010754
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085009455
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 023516
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License Number State | NY
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Taxonomy #9
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA055058
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License Number State | PA
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Taxonomy #10
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA2023-0208
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License Number State | NM
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Taxonomy #11
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9106961
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License Number State | FL
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