Marchioli, Marc Edward

Marchioli, Marc Edward is an individual health care provider with primary practice located at 410 S 11Th St , Lake Wales FL 33853-4203. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Marchioli, Marc Edward can be contacted via phone (407) 303-7283.

Contact Information

Primary practice address
410 S 11Th St Lake Wales FL 33853-4203
Phone: (407) 303-7283
Fax: (407) 303-0473
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 965 Georgia
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 965 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-TF-0188 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA3370 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601010961 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110010754 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085009455 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 023516 New York
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X MA055058 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA2023-0208 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9106961 Florida

Profile Details

NPI number 1639450778
LBN Legal business name Marchioli, Marc Edward
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2011
Last updated Aug 18th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639450778 NPPES
Georgia Other 965 GA STATE LICENSE
Georgia MEDICAID 7100961270 GA STATE LICENSE
Georgia Other MA055058 GA STATE LICENSE
Georgia Other PA2023-0208 GA STATE LICENSE
Georgia Other PA3370 GA STATE LICENSE
Georgia Other PA9106961 GA STATE LICENSE

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