Individual
MR. PAUL ANTHONY LICATA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
601 N FLAMINGO RD, PEMBROKE PINES, FL 33028-1015
(954) 724-0276
Mailing address
8105 NW 94TH AVE, TAMARAC, FL 33321-1441
(954) 724-0276
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102128
FL
Other
Enumeration date
06/03/2006
Last updated
07/08/2007
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