Provider Type Icon

DR. MARK O. LICHT M. D. NPI 1770573982


NPI Information

NPI: 1770573982
Provider Name: DR. MARK O. LICHT, M. D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Address:
1106 DRUID RD S
SUITE 302
CLEARWATER, FL
ZIP 33756
Phone: (727) 441-3711
Get Directions

DR. Mark O. Licht, M. D. is a diagnostic radiology radiology in Clearwater, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Mark O. Licht, M. D. NPI is 1770573982. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1106 DRUID RD S
SUITE 302
CLEARWATER, FL
ZIP 33756-846
Phone: (727) 441-3711

The enumeration date for this NPI number is 10/27/2005 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyME43994FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1D50161MEDICARE UPINFLORIDA
201481OTHERFLORIDABCBS
301481MEDICARE ID-TYPE UNSPECIFIEDFLORIDAMEDICARE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.