M.D. Rudolph F Licandro, NPI 1497753784
Interventional Cardiology Physician in Louisville, KY, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1497753784
NPI Entity Type Individual
Provider Name M.D. Rudolph F Licandro
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 3900 Kresge Way, Ste 60, Louisville, KY, US
Provider Mailing Address Po Box 950248, Louisville, KY, US, 402950248
Gender Male
Is Sole Proprietor? No
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Primary Taxonomy

Taxonomy Code

207RI0011X

Taxonomy Name Interventional Cardiology Physician
Classification

Internal Medicine

Group

Allopathic & Osteopathic Physicians

License No. 23908
License State KY
Description An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Business Address

M.D. Rudolph F Licandro
3900 Kresge Way
Ste 60

Louisville, KY, US

Phone: 502-893-7710
Fax: 502-893-1884

Mailing Address

M.D. Rudolph F Licandro
Po Box 950248
Louisville, KY, US
ZIP 402950248
Phone: 502-489-5730
Fax: 502-489-5753

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

207RC0000X

Allopathic & Osteopathic Physicians

Internal Medicine

23908 KY No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
AL3044512 DEA 01
64239080 KY MEDICAID 05

Health Information Exchange

Endpoint Type Endpoint Description Use Content Type Affiliation Location
DIRECT [email protected] No 3900 Kresge Way, Ste 60, Louisville, KY, US

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DO John M Fleming

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911 Bypass Rd Bldg A

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