Individual provider · Type 1 NPI

Marc Eddy Theodor, PMHNP

Psychiatric/Mental Health Nurse Practitioner · Port Charlotte, FL

NPI number 1750105995 Active

Practice location

3191 Harbor Blvd Ste A
Port Charlotte, FL 33952-6755

Other practice locations

  • 2338 Immokalee Rd # 559, Naples, FL 34110-1445 · (239) 610-0194

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN9555670 (FL)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XAPRN11036065 (FL)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

17 other providers at this address

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About NPI 1750105995

Marc Eddy Theodor, PMHNP's National Provider Identifier is 1750105995, issued on Nov 13, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Port Charlotte, FL. The record was last updated on Jul 1, 2026.