Provider Demographics
NPI:1225411895
Name:HOUCK, MARSHA MARIE
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:MARIE
Last Name:HOUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E. DIXIE AVENUE
Mailing Address - Street 2:ATTN. EDNA P REIMBURSEMENT
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5925
Mailing Address - Country:US
Mailing Address - Phone:352-323-4267
Mailing Address - Fax:352-323-5039
Practice Address - Street 1:910 OLD CAMP RD STE 130
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5609
Practice Address - Country:US
Practice Address - Phone:352-633-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3394122363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health