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Export Provider Record NPI 1174588594
R Paul Liccini Md Llc
Organization Subpart: NO
Active
NPI Number1174588594
NPI TypeNPI-2 Organization
SpecialtyInternal Medicine, Interventional Cardiology
Provider Details
NPI1174588594
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-04-19
Last Updated2010-07-29
Authorized OfficialR. Paul Liccini
Owner
Phone: 2399362220
Mailing Address12645 New Brittany Blvd, Bldg 15
Fort Myers, FL 33907-3631
United States
Phone: (239) 936-2220 | Fax: (239) 936-2444
📍 View Map
Primary Practice Address12645 New Brittany Blvd, Bldg 15
Fort Myers, FL 33907-3631
United States
Phone: (239) 936-2220 | Fax: (239) 936-2444
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)FL=========Tax ID
Other (non-Medicare)FLDG1282Rail Road Medicare
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207RI0011X – Internal Medicine, Interventional Cardiology--
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About NPI 1174588594

R Paul Liccini Md Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1174588594. The primary specialty listed is Internal Medicine, Interventional Cardiology. The organization is located in Fort Myers, FL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-04-19. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1174588594?

NPI 1174588594 belongs to R Paul Liccini Md Llc, a Internal Medicine, Interventional Cardiology in Fort Myers, FL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1174588594 active?

The current status of NPI 1174588594 in the NPPES registry is Active. The record was last updated on 2010-07-29.

What specialty is NPI 1174588594?

NPI 1174588594 is classified under the taxonomy Internal Medicine, Interventional Cardiology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1174588594?

You can verify NPI 1174588594 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1174588594?

The primary practice address on file for NPI 1174588594 is 12645 New Brittany Blvd, Fort Myers, FL 33907-3631. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1174588594 issued?

NPI 1174588594 was first issued (enumerated) on 2006-04-19. The NPPES record was last updated on 2010-07-29.

Practice Location Map

R Paul Liccini Md Llc is located at 12645 New Brittany Blvd, Fort Myers, FL. Use the map below to find directions or verify the practice location.

📍 12645 New Brittany Blvd, Fort Myers, FL 33907-3631  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as R Paul Liccini Md Llc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-08-24 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162