Licht, Mark R
Licht, Mark R is an individual health care provider with primary practice located at 258 S Chickasaw Trl Ste 202 , Orlando FL 32825-3501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Licht, Mark R can be contacted via phone (407) 303-6865.Contact Information
Primary practice address
258 S Chickasaw Trl Ste 202
Orlando FL 32825-3501
Phone: (407) 303-6865
Fax: (407) 303-6537
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ME68004 | Florida |
Profile Details
| NPI number | 1306841473 |
|---|---|
| LBN Legal business name | Licht, Mark R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Jul 17th, 2026 - about 3 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306841473 | NPPES |
| Florida | MEDICAID | 101986000 |
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