Liccini, Raymond Paul
Liccini, Raymond Paul is an sole proprietor health care provider with primary practice located at 16261 Bass Rd Ste 300 , Fort Myers FL 33908. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Liccini, Raymond Paul can be contacted via phone (239) 343-6410.Contact Information
Primary practice address
16261 Bass Rd Ste 300
Fort Myers FL 33908
Phone: (239) 343-6410
Fax: (239) 343-4014
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | ME68201 | Florida |
| Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | ME68201 | Florida |
Profile Details
| NPI number | 1619969078 |
|---|---|
| LBN Legal business name | Liccini, Raymond Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Mar 29th, 2021 - about 3 years ago |
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 | 1619969078 | NPPES |
| Florida | Other | 060070568 | MEDICARE RR |
| Florida | Other | 27065 | MEDICARE RR |
| Florida | MEDICAID | 377898300 | MEDICARE RR |
| Florida | Other | 820580815 | MEDICARE RR |
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