Licitra, Carmelo M
Licitra, Carmelo M is an individual health care provider with primary practice located at 1012 Lucerne Ter , Orlando FL 32806-1015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Licitra, Carmelo M can be contacted via phone (407) 423-1039.Contact Information
Primary practice address
1012 Lucerne Ter
Orlando FL 32806-1015
Phone: (407) 423-1039
Fax: (407) 425-2347
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | ME0042655 | Florida |
Profile Details
| NPI number | 1659347342 |
|---|---|
| LBN Legal business name | Licitra, Carmelo M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 23rd, 2006 |
| Last updated | Jan 30th, 2008 - about 17 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 | 1659347342 | NPPES |
| Florida | Other | 64535 | BCBS |
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