Individual
DR. MICHAEL JOHN LICATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 PINELLAS ST, CLEARWATER, FL 33756-3804
(727) 734-6635
Mailing address
300 PINELLAS ST, CLEARWATER, FL 33756-3804
(727) 462-7062
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0101239523
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME144327
FL
Other
Enumeration date
01/22/2006
Last updated
07/15/2021
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