Licandro, Rudolph F
Licandro, Rudolph F is an individual health care provider with primary practice located at 3900 Kresge Way Ste 60, Louisville KY 40207-4660. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Licandro, Rudolph F can be contacted via phone (502) 893-7710.Contact Information
Primary practice address
3900 Kresge Way Ste 60
Louisville KY 40207-4660
Phone: (502) 893-7710
Fax: (502) 893-1884
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 23908 | Kentucky |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 23908 | Kentucky |
Profile Details
| NPI number | 1497753784 |
|---|---|
| LBN Legal business name | Licandro, Rudolph F |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497753784 | NPPES |
| Kentucky | MEDICAID | 64239080 |
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