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General NPI Number Information
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NPI Number | 1861210718
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Entity Type | Individual
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Provider Name | VINCE J MARCEAU PA-C, MS
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Gender | Male
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 6440 W NEWBERRY RD STE 102
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City | GAINESVILLE
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State | FL
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Zip | 32605-4368
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Country | US
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Telephone | 352-333-5610
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Fax |
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Provider Business Mailing Address
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Address Line | 6440 W NEWBERRY RD STE 102
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City | GAINESVILLE
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State | FL
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Zip | 32605-4368
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Country | US
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Telephone | 586-453-2367
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9120410
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License Number State | FL
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