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Individual

MARK A LIVECCHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15255 MAX LEGGETT PKWY, JACKSONVILLE, FL 32218-7273
(904) 456-8297
(904) 244-9493
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-9092
(904) 244-9493

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
130640
FL
208100000X
Physical Medicine & Rehabilitation Physician
200828
NY
2081P0004X
Spinal Cord Injury Medicine Physician
130640
FL
2081P0301X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
Primary
130640
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01892222
NY
01
P00884039
MEDICARE RAILROAD
NY
Enumeration date
09/12/2005
Last updated
04/19/2026
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