Individual
JONATHAN LICHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-7832
(352) 273-6867
Mailing address
PO BOX 100214, LURIE 5-123, GAINESVILLE, FL 32610-0214
(352) 273-7832
(352) 273-6867
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
36116430
IL
207RX0202X
Medical Oncology Physician
Primary
ME126669
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016546300
—
FL
Enumeration date
11/09/2006
Last updated
02/15/2016
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