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
Fax: (502) 893-1884
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497753784 NPPES
Kentucky MEDICAID 64239080

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