Dicicco, Richard Lark

Dicicco, Richard Lark is an individual health care provider with primary practice located at 508 S Habana Ave Suite 160, Tampa FL 33609-4181. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Dicicco, Richard Lark can be contacted via phone (813) 877-6000.

Contact Information

Primary practice address
508 S Habana Ave Suite 160 Tampa FL 33609-4181
Phone: (813) 877-6000
Fax: (813) 877-6002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME90737 Florida

Profile Details

NPI number 1811989874
LBN Legal business name Dicicco, Richard Lark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Jan 14th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811989874 NPPES
Florida Other 50968 BLUE CROSS BLUE SHIELD FL
Florida Other 7683574 BLUE CROSS BLUE SHIELD FL
Florida Other 307206 BLUE CROSS BLUE SHIELD FL

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