Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marc Eddy Theodor, PMHNP

Individual provider Registered Nurse · NPI 1750105995

Marc Eddy Theodor, PMHNP is a Nurse Practitioner in Port Charlotte, Florida. Qualified in 2024, 2 years ago. Practices with National Psychiatry, LLC, a 9-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
2
Licensed in
FL
In the registry since
2024
Specialties on file
2
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3191 Harbor Blvd Ste A
Port Charlotte, FL 33952-6755
Phone: (941) 883-4518
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence APRN11036065 (FL)
Registered Nurse Taxonomy 163W00000X · Licence RN9555670 (FL)

Record details

NPI number1750105995
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP
Sole proprietorNo
NPI enumeratedNovember 13, 2024
Last updated in NPPESJuly 1, 2026
Certification dateJuly 1, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice National Psychiatry, Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Port Charlotte