Individual
MR. ANTONIO M LICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1 WYOMING ST, 3 FL / ANES. DEPT, DAYTON, OH 45409
(937) 208-4380
(937) 208-3843
Mailing address
P.O. BOX 632317, CINCINNATI, OH 45263-2317
(937) 208-4380
(937) 208-3843
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
34.00512
OH
207L00000X
Anesthesiology Physician
34005132
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0932138
—
OH
Enumeration date
01/04/2006
Last updated
12/02/2010
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