Mark R. Licht, M.D.

Urology Physician · Orlando, FL

Individual Active NPI

NPI number 1306841473

Practice location

258 S Chickasaw Trl Ste 202
Orlando, FL 32825-3501
Phone
(407) 303-6865
Fax
(407) 303-6537

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NPI record

NPI
1306841473
Entity type
Individual (Type 1)
Enumeration date
June 16, 2005
Last updated
July 17, 2026
Certified
July 17, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Urology Physician Primary 208800000X ME68004 FL

Mailing address

805 Century Medical Dr Ste C
Titusville, FL 32796-2100
Phone
(321) 268-6868
Fax
(321) 267-2713

Other practice locations (2)

  • 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3019 · (863) 680-7000
  • 825 Century Medical Dr, Titusville, FL 32796-2113 · (321) 268-6868

About Dr. Licht

Mark R. Licht, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Urology Physician (code 208800000X). The practice location is 258 S Chickasaw Trl Ste 202, Orlando, FL 32825-3501. The NPI number 1306841473 was assigned on June 16, 2005 and the record was last updated on July 17, 2026.

Dr. Licht lists a license in the registry: #ME68004 (FL) for Urology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark R. Licht, M.D.?

The NPI number is 1306841473.

What is the phone number of Dr. Licht?

The phone number listed for the practice location is (407) 303-6865.

Where is Dr. Licht located?

258 S Chickasaw Trl Ste 202, Orlando, FL 32825-3501.

What is the taxonomy code for Dr. Licht?

The primary taxonomy code is 208800000X – Urology Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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