Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Michael John Licata, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1780664961

Dr. Michael John Licata, MD is a Pathology in Clearwater, Florida. Qualified in 2004, 22 years ago. Practices with Clearwater Pathology Associates, a 9-clinician group and accepts Medicare assignment. Licensed in Florida and Virginia.

Years since qualifying
22
Licensed in
FL, VA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

300 Pinellas St
Clearwater, FL 33756-3804
Phone: (727) 734-6635
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence ME144327 (FL)
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X · Licence 0101239523 (VA)

Record details

NPI number1780664961
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 22, 2006
Last updated in NPPESJuly 15, 2021
Certification dateJuly 15, 2021
Mailing address300 Pinellas St, Clearwater, FL 33756-3804

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Clearwater Pathology Associates — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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