DR. RAYMOND PAUL LICCINI


Address: 16261 Bass Rd Ste 300, Fort Myers, FL 33908
Phone: 2393436410

DR. RAYMOND PAUL LICCINI (NPI# 1619969078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619969078
Entity Type Individual
Full Name DR. RAYMOND PAUL LICCINI
Credential M.D.
Practice Address 16261 Bass Rd Ste 300
Fort Myers
FL 33908
Mailing Address Po Box 2147
Fort Myers
FL 33902-2147
Practice Telephone 2393436410
Practice Fax Number 2393434014
Mailing Telephone 2393436410
Mailing Fax Number 2393434014
Enumeration Date 2005-08-22
Last Update Date 2020-09-23
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
ME68201 FL Allopathic & Osteopathic Physicians
N 207UN0901X Nuclear Medicine
Specialization: Nuclear Cardiology
ME68201 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL MEDICARE RR 060070568 01
FL TAX ID 820580815 01
FL BCBS 27065 01
FL 377898300 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
12645 New Brittany Blvd, Bldg 15, Fort Myers, FL 339073631 2399362220 2399362444

Office Location

Street Address 16261 BASS RD STE 300
City FORT MYERS
State FL
Zip Code 33908

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174520464 Sheldon Louis Brownstein Internal Medicine 16261 Bass Rd Ste 300, Fort Myers, FL 33908 2005-07-01
1467944116 Clarice B Wei Nurse Practitioner 16261 Bass Rd Ste 300, Fort Myers, FL 33908 2018-05-30
1104179449 Nicole E Charles Nurse Practitioner 16261 Bass Rd Ste 300, Fort Myers, FL 33908-3671 2012-10-24
1558621375 Steven B Deutsch Internal Medicine 16261 Bass Rd Ste 300, Fort Myers, FL 33908-3671 2012-05-26
1205138880 April Lynn Mccann Nurse Practitioner 16261 Bass Rd Ste 300, Fort Myers, FL 33908 2010-12-02
1497917744 Aditya Reddy Boddu Internal Medicine 16261 Bass Rd Ste 300, Fort Myers, FL 33908-3671 2008-06-27
1073589743 Robert D Glassman Internal Medicine 16261 Bass Rd Ste 300, Fort Myers, FL 33908 2006-02-23

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760081806 1 Recovery Community/Behavioral Health 111 Daniels Dr, Fort Myers, FL 33908 2020-10-20
1457916462 Avipharm, LLC Pharmacy 7669 Calistoble Loop, 2nd Floor, Fort Myers, FL 33908 2019-05-06
1013492289 Craig M Stein Pharmacist 15236 Tropic Bird Court, Fort Myers, FL 33908 2018-10-03
1730665167 Kyndra Lynn Petrick Psychiatry & Neurology 8560 Big Mangrove Dr, Fort Myers, FL 33908 2018-07-18
1447757547 Douglas L Jarrett Nurse Practitioner 16261 Bass Rd Suite 300, Fort Myers, FL 33908 2018-04-06
1447754825 Luis Daniel Ramos General Practice 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 2018-03-21
1619497062 Vanesa Paola Vaquer Dentist 18070 S Tamiami Trl Ste 101, Fort Myers, FL 33908 2017-06-26
1962859603 Teresa Ruiz Behavior Technician 15081 Woodrich Bend Ct Apt 416, Fort Myers, FL 33908 2016-05-23
1669865721 Elena B. Alexiev Dentist 18070 S. Tamiami Trail, #101, Fort Myers, FL 33908 2015-03-13
1134488919 Cecelia Anne Collins Dietitian, Registered 9215 Calle Arragon Avenue, Unit 205, Fort Myers, FL 33908 2012-05-14
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Taxonomy Information

Taxonomy Code 207RI0011X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Interventional Cardiology

Taxonomy Definition

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)

Providers in the same taxonomy and city

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
1174588594 R Paul Liccini Md LLC Internal Medicine 12645 New Brittany Blvd, Bldg 15, Fort Myers, FL 33907-3631 2006-04-19
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

Providers in the same taxonomy and state

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
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Competitor

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City FORT MYERS
Zip Code 33908

Improve Information

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Dataset Information

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.

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