Provider Demographics
NPI:1447766449
Name:LICURA, LLC
Entity type:Organization
Organization Name:LICURA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:FLORSHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-900-6382
Mailing Address - Street 1:20220 BOCA WEST DR APT 1004
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4717
Mailing Address - Country:US
Mailing Address - Phone:561-900-6382
Mailing Address - Fax:
Practice Address - Street 1:599 W HARTSDALE AVE STE 203A
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1847
Practice Address - Country:US
Practice Address - Phone:914-966-4305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-28
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center