R Paul Liccini MD LLC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

R PAUL LICCINI MD LLC

Practice address

12645 New Brittany Blvd
BLDG 15
Fort Myers, FL 33907-3631

Phone

(239) 936-2220

Fax

(239) 936-2444

NPI assigned

Apr 19, 2006

Last updated

Jul 29, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. R. Paul Liccini, M.D.

Title

Owner

Phone

(239) 936-2220

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1174588594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12645 NEW BRITTANY BLVD",
            "address_2": "BLDG 15",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073631",
            "telephone_number": "239-936-2220",
            "fax_number": "239-936-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12645 NEW BRITTANY BLVD",
            "address_2": "BLDG 15",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073631",
            "telephone_number": "239-936-2220",
            "fax_number": "239-936-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R PAUL LICCINI MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "LICCINI",
        "authorized_official_first_name": "R. PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-936-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DG1282",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susana Quintero, M.S.
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• Amir Qureshi, MD
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• R.C.F Home Health Care Agency, LLC
• Eric Raab, D.O.
• Robert Raab, M-CAP
• Stephen Leo Raben, M.D.

• Interventional Cardiology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Interventional Cardiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.