MEDICARE: LICHT MEDICAL CONSULTANTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	204D00000X	Neuromusculoskeletal Medicine & OMM Physician
2	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician
3	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1558953968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LICHT MEDICAL CONSULTANTS, LLC

Provider Business Mailing Address
First Line	:	1100 N LYLE AVE
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-8741
Country	:	US
Telephone Number	:	352-320-2007
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 N LYLE AVE
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-8741
Country	:	US
Telephone Number	:	352-320-2007
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH LICHT
Credential	:	DO
Telephone Number	:	325-509-6266

Provider Enumeration Date	:	02/07/2021
Last Update Date	:	01/26/2026

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