R PAUL LICCINI MD LLC (NPI# 1174588594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174588594 |
| Entity Type | Organization |
| Organization Name | R PAUL LICCINI MD LLC |
| Practice Address |
12645 New Brittany Blvd Bldg 15 Fort Myers FL 33907-3631 |
| Practice Telephone | 2399362220 |
| Practice Fax Number | 2399362444 |
| Mailing Telephone | 2399362220 |
| Mailing Fax Number | 2399362444 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2010-07-29 |
| Authorized Official Name | DR. R. PAUL LICCINI (OWNER) |
| Authorized Official Telephone | 2399362220 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAIL ROAD MEDICARE | DG1282 | 01 |
| Street Address |
12645 NEW BRITTANY BLVD BLDG 15 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33907-3631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952478174 | Frederick W Kunkel | Internal Medicine | 12645 New Brittany Blvd, Bldg 15, Fort Myers, FL 33907-3631 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739253 | Islande Dorcin | Social Worker | 13300 South Cleveland Ave Suite 56 # 822, Fort Myers, FL 33907 | 2020-08-04 |
| 1003462268 | Ronny Rodolfo Herrera | Behavior Technician | Beacon Executive Suites, 8359 Beacon Blvd, Suite#416, Homestead, FL 33907 | 2019-08-14 |
| 1528549094 | Deborah Senese Streater | Dentist | 12530 New Brittany Blvd., Fort Myers, FL 33907 | 2018-08-23 |
| 1437648391 | Rita Lusinete Rabitt | Registered Nurse | 14084 Clear Water Ln, Fort Myers, FL 33907 | 2018-05-07 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1740787761 | Care Transport Inc | Non-emergency Medical Transport (VAN) | 7850 Reflection Cove Dr, Fort Myers, FL 33907 | 2018-04-06 |
| 1942730692 | Concierge Care of Fort Myers, LLC | In Home Supportive Care | 12253 New Brittany Boulevard, Suite 32, Fort Myers, FL 33907 | 2017-06-15 |
| 1710411467 | Johnnie Terrell | Social Worker | 43 Barkley Cir #102, Fort Myers, FL 33907 | 2017-04-19 |
| 1881041184 | Hchs Medical Center | Clinic/Center | 35 Barkley Circle, Unit 2, Fort Myers, FL 33907 | 2016-05-17 |
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| Find all providers in zip 33907 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013415371 | Cardiac Cin of Naples LLC | Internal Medicine | 8831 Business Park Dr Ste 301c, Fort Myers, FL 33912-2510 | 2018-01-31 |
| 1750763777 | Sunshine Cardiovascular Services | Internal Medicine | 8695 College Pkwy, Fort Myers, FL 33919-4809 | 2015-06-25 |
| 1821350539 | Nemalan Selvaraj | Internal Medicine | 13340 Metro Parkway, Suite 200, Fort Myers, FL 33966-4703 | 2012-06-10 |
| 1174755714 | Kamaldeep Singh | Internal Medicine | 16261 Bass Rd, Suite 300, Fort Myers, FL 33908-3671 | 2009-08-16 |
| 1366414682 | James A. Conrad | Internal Medicine | 16261 Bass Rd, Suite 300, Fort Myers, FL 33908 | 2006-02-02 |
| 1700857356 | Robert M. Grohowski | Internal Medicine | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2006-01-31 |
| 1619969078 | Raymond Paul Liccini | Internal Medicine | 16261 Bass Rd Ste 300, Fort Myers, FL 33908 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861004277 | Steve Malosky Md LLC | Internal Medicine | 900 Sw Saint Lucie Cres, Stuart, FL 34994-2842 | 2020-08-18 |
| 1881212744 | North Broward Hospital District | Internal Medicine | 817 S University Dr Ste 104, Plantation, FL 33324-3345 | 2020-07-08 |
| 1821612821 | Satish Sivasankaran Md Pa | Internal Medicine | 5340 Gulf Dr Ste 101, New Port Richey, FL 34652-3922 | 2020-06-04 |
| 1699317933 | Abid A Shah Md LLC | Internal Medicine | 5741 Bee Ridge Rd Ste 420, Sarasota, FL 34233-5081 | 2019-10-08 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1205329620 | Central Florida Cardiovascular Imaging Center, LLC | Internal Medicine | 1717 Mayo Dr, Tavares, FL 32778-4307 | 2018-06-11 |
| 1568953511 | Orlando Lopez-fernandez Jr. | Internal Medicine | 2800 Ponce De Leon Blvd Ste 1480, Coral Gables, FL 33134-6921 | 2018-05-25 |
| 1467959668 | Cardiology Practice Pa | Internal Medicine | 5051 Ashington Landing Dr, Tampa, FL 33647-3515 | 2018-04-12 |
| 1619476785 | Synergy Health Group LLC | Internal Medicine | 7828 Collins Grove Rd, Jacksonville, FL 32256-7175 | 2018-02-05 |
| 1114425477 | Cardiac Cin of Miami LLC | Internal Medicine | 2 S Biscayne Blvd Ste 3760c, Miami, FL 33131-1815 | 2018-01-31 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33907 |
Please comment or provide details below to improve the information on R PAUL LICCINI MD LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.