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Contact Information

RAYMOND P LICCINI, MD
16261 BASS RD STE 300
FORT MYERS, FL33908
 Phone: 239-343-6410
 Fax: 239-343-4014
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
 

Nuclear Cardiology

207UN0901X 36 Physician/Nuclear Medicine
Indicates primary specialty

NPI Profile & details for RAYMOND P LICCINI · (Male)

NPI # 1619969078
Status Active
Credentials MD
Entity Individual
Enumeration date 08/22/2005
Last updated 03/29/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # ME68201
  • FL Medicaid 377898300
  • FL Other 27065 BCBS
  • FL Other 060070568 MEDICARE RR
  • FL Other 820580815 TAX ID
Hospital affiliation(s)
  • CAPE CORAL HOSPITAL - (Acute Care)
    636 DEL PRADO BLVD
    CAPE CORAL, FL 33990
  • LEE MEMORIAL HOSPITAL - (Acute Care)
    2776 CLEVELAND AVE
    FORT MYERS, FL 33901
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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