Provider Demographics
NPI:1780673509
Name:PEIPER, MARC IAN (ARNP)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:IAN
Last Name:PEIPER
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 LAKE UNDERHILL RD STE 215
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4511
Mailing Address - Country:US
Mailing Address - Phone:321-235-0692
Mailing Address - Fax:213-235-0694
Practice Address - Street 1:12301 LAKE UNDERHILL RD STE 215
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4511
Practice Address - Country:US
Practice Address - Phone:321-235-0692
Practice Address - Fax:213-235-0694
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3413732363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308164800Medicaid
FLU4369YMedicare PIN
FL308164800Medicaid