Teresa Liccardi, M.D., PLLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

TERESA LICCARDI, M.D., PLLC

Practice address

1153 10TH Ave N
Naples, FL 34102-5425

Phone

(980) 461-8050

NPI assigned

Jul 7, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Teresa Marie Liccardi, MDNPI 1295908598

Title

Sole Proprietor/ Administrator

Phone

(908) 461-8050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Teresa Marie Liccardi, M.D.

  • Nephrology Physician
  • Naples, FL
  • NPI 1295908598
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1336710748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 10TH AVE N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025425",
            "telephone_number": "980-461-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 10TH AVE N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025425",
            "telephone_number": "980-461-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESA LICCARDI, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "LICCARDI",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SOLE PROPRIETOR/ ADMINISTRATOR",
        "authorized_official_telephone_number": "908-461-8050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Naples, FL
• Providers in Naples, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.