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Dr. Mark R Licht, MD
Urology Physician in Titusville, Florida
NPI 1306841473

Mark R Licht is a Urology Physician based in Titusville, FL. Mark R Licht practices in Titusville, FL and has the professional credentials of MD. The NPI Number for Mark R Licht is 1306841473 and holds a License No. ME68004 (Florida).

The current practice location address for Mark R Licht is 825 Century Medical Dr, Titusville, FL and can be reached out via phone at 321-268-6868 and via fax at 321-267-2713. You can also correspond with Mark R Licht through the mailing address at 805 CENTURY MEDICAL DR STE C, TITUSVILLE, FL - 32796-2100 (mailing address contact number: 321-268-6868).

Location: 825 Century Medical Dr, Titusville, FL, 32796-2100
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306841473
Provider Name
Mark R Licht
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
825 Century Medical Dr, Titusville, FL, 32796-2100
Phone Number
321-268-6868
Fax Number
321-267-2713
Provider Enumeration Date
06/16/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101986000 05 FL
institution
Provider Business Practice Location Address Details
Address
825 Century Medical Dr
City
Titusville
State
Florida
Zip
32796-2113
Phone Number
321-268-6868
Fax Number
321-267-2713
person
Provider Business Mailing Address Details
Address
825 Century Medical Dr
City
Titusville
State
Florida
Zip
32796-2113
Phone Number
321-268-6868
Fax Number
321-267-2713
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
ME68004 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
208800000X
License No.
ME68004 (Florida)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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