Provider Demographics
NPI:1770670457
Name:HOFELDT, MARCHELLE KAY (MD)
Entity Type:Individual
Prefix:
First Name:MARCHELLE
Middle Name:KAY
Last Name:HOFELDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2082 SYKES CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3065
Mailing Address - Country:US
Mailing Address - Phone:321-848-8889
Mailing Address - Fax:
Practice Address - Street 1:2082 SYKES CREEK DR
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3065
Practice Address - Country:US
Practice Address - Phone:321-848-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 82565207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261687400Medicaid
FLH42106Medicare UPIN
FL261687400Medicaid